title: Effectiveness of hyaluronic acid administration in treating adhesive capsulitis of the shoulder: a systematic review of randomized controlled trials.
abstract: BACKGROUND
  Adhesive capsulitis (AC) of the shoulder presents with an insidious onset of pain and progressive limitation of shoulder movement.
  
  
  OBJECTIVE
  To investigate whether intra-articular hyaluronic acid (HA) administration alone is superior to conventional therapies and whether the addition of intra-articular HA administration to conventional therapies improves clinical outcomes in patients with AC.
  
  
  METHODS
  The PubMed, EMBASE, CINAHL, and Cochrane Library electronic databases were searched without language restrictions in July 2014 with a priori defined inclusion and exclusion criteria.
  
  
  RESULTS
  Four randomized controlled trials (273 participants, 278 shoulders) were included in this review. Two trials compared intra-articular HA administration with conventional therapies and 2 trials evaluated intra-articular HA administration as an addition to conventional therapies. Pain and shoulder function/disability outcomes in the HA injection group were not superior to those achieved in the conventional therapy groups. No significant differences in pain or shoulder function/disability outcomes were noted between the groups with and without adjunctive HA administration.
  
  
  CONCLUSIONS
  Intra-articular HA administration alone is not superior to conventional AC treatments, and the addition of intra-articular HA administration to conventional therapies does not provide significant added benefits. HA administration in AC patients who are receiving conventional therapies should be evaluated to avoid unnecessary medical expenditure.
authors: Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei 11220, Taiwan.
authors: Lin-Chien
authors: 0000-0002-4391-5134
authors: LC
authors: Lee
authors: Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei 11220, Taiwan.
authors: Fu-Kong
authors: 0000-0001-9568-7973
authors: FK
authors: Lieu
authors: Department of Nursing, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
authors: Hung-Lin
authors: 0000-0002-7938-0303
authors: HL
authors: Lee
authors: Department of Medical Research and Education, Cheng Hsin General Hospital, Taipei 11220, Taiwan ; Department of Public Health, School of Medicine, Fu Jen Catholic University, Taipei 24205, Taiwan.
authors: Tao-Hsin
authors: 0000-0003-2097-8375
authors: TH
authors: Tung
mesh_terms: D002062:Bursitis / Q000188:drug therapy*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012785:Shoulder Joint / Q000187:drug effects*; D020069:Shoulder Pain / Q000188:drug therapy*
chemical_list: D006820:Hyaluronic Acid