title: Ultrasound-guided viscosupplementation of subacromial space in elderly patients with cuff tear arthropathy using a high weight hyaluronic acid: prospective open-label non-randomized trial.
abstract: OBJECTIVE
  To assess if ultrasound (US)-guided viscosupplementation can reduce pain and improve function in elderly patients with cuff tear arthropathy.
  
  
  METHODS
  Ninety-three patients aged over 65 with grade 3 or above cuff tear arthropathy were included in this prospective open-label non-randomized trial. Institutional review board approval and informed consent were obtained. Thirty-three patients received intra-articular injections of sodium hyaluronate under US guidance. Sixty patients constituted the control group. Shoulder joint function was assessed with Constant scores (CS) and pain with a visual analogue scale (VAS).
  
  
  RESULTS
  Compared with controls, treated patients reported a significant decrease in symptoms at 1 (mean CS 66±3.1 vs 37±6.9; mean VAS 1.9±1.2 vs 6.9±2.2), 2 (mean CS 65±3.2 vs 35±7.2; mean VAS 1.7±1.2 vs 6.8±2.5), 3 (mean CS 66±3.4 vs 33 6.1; mean VAS 2.3±1.2 vs 6.6±1.9), and 4 (mean CS 62±3.0 vs 34±6.5; mean VAS 3.3±1.4 vs 7.8±3.1) months, p<0.001. After 5 months there were no differences.
  
  
  CONCLUSIONS
  US-guided viscosupplementation is a beneficial therapeutic option in the first months of treatment.
authors.affiliation: Department of Radiology, National Institute for Cancer Research, Largo Rosanna Benzi 10, 16132, Genoa, Italy. atagliafico@sirm.org
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serafini
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Sconfienza
authors.forename: Francesca
authors.initials: F
authors.lastname: Lacelli
authors.forename: Nadia
authors.initials: N
authors.lastname: Perrone
authors.forename: Giulia
authors.initials: G
authors.lastname: Succio
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D010146:Pain / Q000188:drug therapy*; D012782:Shoulder / Q000000981:diagnostic imaging / Q000473:pathology; D000070599:Shoulder Injuries; D016896:Treatment Outcome; D014465:Ultrasonics; D014463:Ultrasonography; D055676:Viscosupplementation; D055675:Viscosupplements / Q000627:therapeutic use*
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid