Hyaluronic acid as an alternative treatment option for degenerative rotator cuff tears


Rotatorcuff tears; conservative treatment; hyaluronic acid; shoulder

Published online: Feb 17 2023


Philip Tack, Sofie Vanhaverbeke, Lieven De Wilde, Alexander Van Tongel

From the Ghent University, Faculty of Medicine and Health Sciences, Department of Orthopedics and Traumatology, Ghent, Belgium


Rotator cuff tears have a high prevalence in older people. This research examines the clinical outcome of the non-operative treatment of symptomatic degenerative rotator cuff tears with hyaluronic acid (HA) injections.

72 patients (43 females/29 males), with an average age of 66 years with symptomatic degenerative full- thickness rotator cuff tear, confirmed with arthro-CT, were treated with three intra-articular hyaluronic acid injections and followed on multiple observational moments during a 5-year follow-up using the SF- 36 (Short-Form Health Survey), DASH (Disabilities of the Arm, Shoulder, and Hand), CMS (Constant Murley Score), and OSS (Oxford Shoulder Scale.

54 patients completed the 5-year follow-up questionnaire. 77% of the patients did not require additional treatment for their shoulder pathology, and 89% were treated conservatively. Only 11% of the patients included in this study needed surgery. Between subjects, the analysis revealed a significant difference in response in the DASH (p=0.015) and CMS (p=0.033) when the subscapularis muscle was involved.

Intra-articular infiltrations with hyaluronic acid improve pain and shoulder function, especially if the subscapularis muscle is not involved.