OSTENIL HYALURONAN FOR INOPERABLE ARTHRITIS OF THE SHOULDER
Authors: L Funk
References: Osteoarthritis & Cartilage 2004; 12(Suppl B)
Aim: The aim of this study was to assess the efficacy of Ostenil in the treatment of shoulder arthritis in patients not suitable for shoulder replacement surgery.
Methods: Seven patients presenting to a busy shoulder service over a two year period were found to have disabling arthritis of the shoulder, but were too medically unfit or refused shoulder replacement surgery. All patients received a course of three Ostenil injections into the glenohumeral joint at weekly intervals. Patients were assessed pre-injection and at three months post-injection using the Constant Score and additional quality of life questions.
Results: The mean patient age was 83 years (range 72 to 93), including six females and one male. Five patients had osteoarthritis, one rheumatoid arthritis and one cuff arthropathy. The mean pre-injection Constant Score was 15.5 (10-25). The mean Constant Score at three months was 49.5 (25-84). Pain was improved significantly by the injections from 11.6 (10-14) to 4.7 (0-9). All patients had their sleep disturbed by pain prior to the injections. Only three had some disturbance of sleep at three months post-injection, with none having their sleep disturbed at all times after the injections. Subjective shoulder elevation improved from chest level to hand above head, whilst objectively it improved from 61.8 degrees (30-90) to 92.1 degrees (60-130). Patient satisfaction (on a scale of 0 to 10) improved from 1.3 (0-2) pre-injection to 8.4 (4-10) following the injections (Table 1).
Conclusions: Ostenil Hyaluronan appears to reduce pain and improve patient satisfaction in patients with advanced arthritis of the shoulder.
Table of Results Pre-injection 3 months post-injection Constant Score 15.5 (10-25) 49.5 (25-84) Pain (VAS:0-15) 11.6 (10-14) 4.7 (0-9) Subjective Range of Motion Chest level Above Head Shoulder Elevation 61.8 degrees (30-90) 92.1 degrees (60-130) Patient Satisfaction (%) 13 (0-20) 84 (40-100)