• Lin-Chien Lee, Fu-Kong Lieu, Hung-Lin Lee, and Tao-Hsin Tung.
• Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei 11220, Taiwan.
• Biomed Res Int. 2015 Jan 1; 2015: 314120.

IntroductionAdhesive capsulitis (AC) of the shoulder presents with an insidious onset of pain and progressive limitation of shoulder movement.ObjectivesTo 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.MethodsThe PubMed, EMBASE, CINAHL, and Cochrane Library electronic databases were searched without language restrictions in July 2014 with a priori defined inclusion and exclusion criteria.ResultsFour 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.ConclusionsIntra-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.

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