title: Clinical evidence in the treatment of rotator cuff tears with hyaluronic acid.
abstract: OBJECTIVE
  the aim of this quantitative review is to document potential benefit and adverse effects of hyaluronic acid (HA) injection into the shoulder with rotator cuff tears.
  
  
  METHODS
  a systematic literature search was performed in english PubMed, Medline, Ovid, Google Scholar and Embase databases using the combined key words "hyaluronic acid", "rotator cuff tear", "hyaluronate", "shoulder", "viscosupplementation", with no limit regarding the year of publication. Articles were included if they reported data on clinical and functional outcomes, complications in series of patients who had undergone HA injection for management of rotator cuff tears. Two Authors screened the selected articles for title, abstract and full text in accordance with predefined inclusion and exclusion criteria. The papers were accurately analyzed focusing on objective rating scores reported.
  
  
  RESULTS
  a total of 11 studies, prospective, 7 were randomized were included by full text. A total of 1102 patients were evaluated clinically after different HA injection compare with corticosteroid injection, physically therapies, saline solution injection and control groups. The use of HA in patients with rotator cuff tears improve VAS and functional score in all trials that we have analyzed.
  
  
  CONCLUSIONS
  intra-articular injection with HA is effective in reducing pain and improving function in shoulder with rotator cuff tears and without severe adverse reaction.
  
  
  METHODS
  Level I.
authors.affiliation: Unit of Arthroscopy and Sports Medicine, Hesperia Hospital, Modena, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Osti
authors.affiliation: Department of Orthopaedic and Traumatology, University of Ferrara, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Buda
authors.affiliation: Department of Orthopaedic and Trauma Surgery Hospital Sant'Anna, Como, Italy.
authors.forename: Angelo Del
authors.initials: AD
authors.lastname: Buono
authors.affiliation: Department of Orthopaedic and Traumatology, University of Ferrara, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Osti
authors.affiliation: Department of Orthopaedic and Traumatology, University of Ferrara, Italy.
authors.forename: Leo
authors.initials: L
authors.lastname: Massari
keywords: cuff tears; glenohumeral; hyaluronate; hyaluronic acid; shoulder; viscosupplementation