Background:

Rotator cuff pathology is a common cause of pain and shoulder dysfunction. Several nonoperative treatment modalities have been developed for rotator cuff lesions, but their relative efficacy is not well-established.

Purpose/Hypothesis:

The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of sodium hyaluronate (SH) in the treatment of patients with rotator cuff lesions. It was hypothesized that SH would be found to be more effective than other nonoperative regimens.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

We searched various databases to identify eligible studies that evaluated the effects of SH on the pain and shoulder dysfunction attributed to rotator cuff lesions. Outcome measures were pain visual analog scale (VAS) score; Constant score; University of California, Los Angeles (UCLA) score; satisfaction rate; complications; and factors affecting the pain VAS score. Outcomes were reported as weighted mean difference (WMD) or risk ratio.

Results:

A total of 9 studies were identified for data analysis. Compared with patients treated with other nonoperative treatments (controls), those treated with SH had significantly improved pain VAS scores at 1 week (WMD = −0.95; 95% CI, −1.75 to −0.16; P = .019), 2 weeks (WMD = −1.05; 95% CI, −2.07 to −0.03; P = .044), 3 weeks (WMD = −1.49; 95% CI, −2.88 to −0.11; P = .035), and 4 weeks (WMD = −2.12; 95% CI, −4.05 to −0.19; P = .031). The Constant score was significantly improved in the SH group versus controls at 2 weeks (WMD = 3.25; 95% CI, 2.36 to 4.13; P < .001), 3 months (WMD = 20.28; 95% CI, 0.54 to 40.03; P = .044), and 6 months (WMD = 5.58; 95% CI, 0.94 to 10.21; P = .018). The UCLA score and satisfaction rate did not differ significantly between the 2 groups. No complications associated with SH were reported in the included studies. Metaregression analysis showed that, except for study design (coefficient = −1.64; 95% CI, −2.64 to −0.63; P = .002), none of the variables (sample size, tear type, control treatments) significantly predicted the difference in VAS pain score between SH and other treatments.

Conclusion:

The present meta-analysis demonstrated that SH was effective in treating patients with rotator cuff lesions.

中文翻译：

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透明质酸钠治疗肩袖损伤的效果：系统评价和荟萃分析

背景：

肩袖病变是疼痛和肩部功能障碍的常见原因。已经为肩袖损伤开发了几种非手术治疗方式，但它们的相对疗效尚不明确。

目的/假设：

本系统评价和荟萃分析的目的是评估透明质酸钠 (SH) 治疗肩袖损伤患者的疗效和安全性。假设发现 SH 比其他非手术方案更有效。

学习规划：

系统审查；证据水平，3。

方法：

我们搜索了各种数据库，以确定评估 SH 对归因于肩袖损伤的疼痛和肩部功能障碍的影响的合格研究。结果测量是疼痛视觉模拟量表（VAS）评分；恒定分数；加州大学洛杉矶分校（UCLA）分数；满意率；并发症；以及影响疼痛VAS评分的因素。结果报告为加权平均差 (WMD) 或风险比。

结果：

共有 9 项研究被确定用于数据分析。与接受其他非手术治疗的患者（对照）相比，接受 SH 治疗的患者在 1 周时疼痛 VAS 评分显着改善（WMD = -0.95；95% CI，-1.75 至 -0.16；P = .019），2 周（ WMD = -1.05；95% CI，-2.07 至 -0.03；P = .044），3 周（WMD = -1.49；95% CI，-2.88 至 -0.11；P = .035）和 4 周（WMD = -2.12；95% CI，-4.05 至 -0.19；P = .031）。在 2 周（WMD = 3.25；95% CI，2.36 至 4.13；P < .001）、3 个月（WMD = 20.28；95% CI，0.54 至 40.03；P = .044）和 6 个月（WMD = 5.58；95% CI，0.94 至 10.21；P= .018)。UCLA 评分和满意度在 2 组之间没有显着差异。在纳入的研究中没有报告与 SH 相关的并发症。元回归分析表明，除了研究设计（系数 = -1.64；95% CI，-2.64 至 -0.63；P = .002）外，没有一个变量（样本量、撕裂类型、对照治疗）显着预测SH 与其他治疗之间的 VAS 疼痛评分。

结论：

目前的荟萃分析表明，SH 可有效治疗肩袖损伤患者。