Indian Journal of Orthopaedics

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 53  |  Issue : 5  |  Page : 595--601

Does hyaluronan improve pain or function following arthroscopic subacromial decompression (ASD) surgery of shoulder? Results of a level 1 RCT


Praveen Sarda1, David Butt2, Sherif Elnikety2, Claire Fitzgerald2, Steven Corbett2 
1 Department of Orthopaedics, Manchester University Hospital NHS Trust, Manchester, UK
2 Department of Orthopaedics, Guy's and St Thomas Hospital NHS Trust, London, UK

Correspondence Address:
Dr. Praveen Sarda
Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL
UK

Background: Sodium hyaluronate (hyaluronan) can be used as a synovial fluid substitute following arthroscopic surgery. In this study, we examined its effect on pain and function following arthroscopic subacromial arthroscopic decompression (ASAD). Methodology: A prospective, randomized, and single-blinded design was used (13/LO0427) to compare the effect of a single postprocedure subacromial instillation of 10 ml hyaluronan, against 10 ml saline control. All patients had interscalene block along with general anesthesia and followed standard postoperative rehabilitation protocol. A power calculation for a 6-point difference in Oxford Shoulder Score (OSS) indicated a minimum sample size of 44. Participants were assessed preoperatively, and at 12 weeks using the following outcome measures -Oxford Shoulder Score (OSS), visual analog score (VAS), European quality of life score (EUROQOL), and Disability of the arm, shoulder, and hand (DASH) scores. Results: 46 patients were included for analysis. Both groups showed a mean improvement in OSS of 9 points (P = 0.0001), DASH (10 points, P < 0.05), and EUROQOL (0.13, P < 0.05). No significant difference was observed between groups in any of the recorded outcomes. Apart from one case of frozen shoulder in each group, no other complications were noted. Conclusion: While both groups showed improved pain and function scores after ASAD, no significant difference was seen between groups receiving placebo or hyaluronan. The intervention is safe but, in this study, has not been shown to improve postoperative pain or function over ASAD alone. Level of evidence: I.


How to cite this article:
Sarda P, Butt D, Elnikety S, Fitzgerald C, Corbett S. Does hyaluronan improve pain or function following arthroscopic subacromial decompression (ASD) surgery of shoulder? Results of a level 1 RCT.Indian J Orthop 2019;53:595-601


How to cite this URL:
Sarda P, Butt D, Elnikety S, Fitzgerald C, Corbett S. Does hyaluronan improve pain or function following arthroscopic subacromial decompression (ASD) surgery of shoulder? Results of a level 1 RCT. Indian J Orthop [serial online] 2019 [cited 2019 Aug 23 ];53:595-601
Available from: http://www.ijoonline.com/article.asp?issn=0019-5413;year=2019;volume=53;issue=5;spage=595;epage=601;aulast=Sarda;type=0