The Role of Hyaluronic Acid in Sport-Related Tendinopathies: A Narrative Review

Crimaldi, Sergio; Liguori, Sara; Tamburrino, Pasquale; Moretti, Antimo; Paoletta, Marco; Toro, Giuseppe; Iolascon, Giovanni

doi:10.3390/medicina57101088

Cited by 13 publications

(16 citation statements)

References 44 publications

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“…Other than injections of sodium hyaluronate, there was no intervention that gave more than temporary relief. Crimaldi et al [ 25 ] reviewed HA for use in tendinopathies in a recent publication. They cited preclinical studies with a mechanism of action that included reduction of proinflammatory markers, improved tenocyte viability and tendon repair.…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic acid injections for chronic tennis elbow

Zinger

Bregman

Safran

et al. 2022

BMC Sports Sci Med Rehabil

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Background For most patients, tennis elbow (TE) resolves within 6 months of onset. For those with persistent and painful TE, nonsurgical treatment options are limited. Thousands of studies have tried to find effective treatments for TE but have usually failed. In this study, we tested the hypothesis that injections with hyaluronic acid (HA) would be effective at reducing pain from chronic TE. Methods Patients with a minimum of six months of pain from TE and with a pain level of 50 or greater (out of 100) were included in the study. They were randomized equally into one of two treatment groups: injection with HA or injection with saline control. Follow-up was conducted at 3, 6 and 12 months from the initial injection. Both the patient and the examiner at the follow-up visits were blinded to the treatment arm. The primary outcome measure was the visual analog scale (VAS pain) score at one year. Additional outcome measures included the shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and Patient Rated Tennis Elbow Evaluation (PRTEE) scores. Results Eighteen patients were randomized into the HA injection treatment arm, and 17 (94%) completed the study. The average age was 51.9 years, and 10 of the subjects were male. Patients had an average of 28.1 months of pain before entering the study. The VAS score in the HA group decreased from a baseline of 76.4–14.3 at 12 months. All 17 patients in the HA group showed VAS score reductions above the minimal clinically important difference (MCID) of at least 18. The PRTEE score improved from 67 to 28.1. The QuickDASH score improved from 53.7 to 22.5. Follow-up in the saline group was less than 50% and was therefore not used as a comparator. Conclusions HA injections yielded significant success in pain relief by three months. Patients continued to improve for the 12-month duration of the study. This study indicates that patients with chronic lateral epicondylitis may benefit from receiving injections of hyaluronic acid rather than having to undergo surgery.

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Section: Discussionmentioning

confidence: 99%

Hyaluronic acid injections for chronic tennis elbow

Zinger

Bregman

Safran

et al. 2022

BMC Sports Sci Med Rehabil

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“…Hyaluronic acid (HA) injection, notably, represents an effective and safe option in the treatment of articular pain in athletes, with recent evidence suggesting a potential effect in accelerating RTP [122,133]. To date, the Osteoarthritis Research Society International classification [134] reported that HA injections might be a recommended mini-invasive procedure to treat even early osteoarthritis in older athletes [122].…”

Section: Invasive Pain Management: What Role For Infiltrations In Athletes?mentioning

confidence: 99%

“…In particular, the recent review by da Costa [135] supported HA injection in a multimodal treatment of patellar chondropathy. Moreover, given the lack of doping issues [136], HA injection represent a feasible and safe therapy for sport-related injuries in elite athletes [122,133]. However, in severely injured athletes, who have no benefit from conventional therapies, mini-invasive procedures should be taken into consideration [131,132].…”

Section: Invasive Pain Management: What Role For Infiltrations In Athletes?mentioning

confidence: 99%

Pharmacological Treatment for Acute Traumatic Musculoskeletal Pain in Athletes

et al. 2021

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Pain management is a crucial issue for athletes who train and compete at the highest performance levels. There are still evidence gaps for the use of analgesics for sports injuries despite the growing interest in training and competition settings. However, high-quality research is needed to determine the most appropriate and optimal timing and formulations in non-steroidal anti-inflammatory drug and opioid management, particularly given the strictness of anti-doping regulations. Indeed, the role of pharmacological therapy in reducing acute traumatic pain in athletes should still be addressed to minimize the timing of return to sport. Therefore, the aim of this comprehensive review was to summarize the current evidence about pain management in the setting of acute injury in elite athletes, providing the most informed strategy for pain relief and performance recovery.

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“…Evidence about management strategies of shoulder pain conditions support the use of rehabilitative intervention as first line approach 2‐4 . Among these, intra‐articular and peritendinous injections with different agents, are minimally invasive approaches routinely performed in clinical practice 5‐9 . Glucocorticoids are the most used drugs intra‐articularly administered to treat musculoskeletal disorders, including shoulder pain.…”

Section: Introductionmentioning

confidence: 99%