The effects of intra-articular hyaluronate injections in young (<55 years) patients with glenohumeral joint osteoarthritis

Abstract

Purpose: Glenohumeral joint (GHJ) osteoarthritis (OA) in younger patients represents a challenging problem. This study assessed the efficacy of intra-articular hyaluronate injection in patients below the age of 55 years. Methods: We reviewed our patient database from August 2013 to December 2016 for patients who received a fluoroscopic-guided intra-articular injection of hyaluronate. Those who had received interventional procedures within the preceding 12 months were excluded. We evaluated the response to the injection using the Oxford Shoulder Score (OSS). These scores were recorded before injection and at 6 weeks, 12 weeks, and 26 weeks postinjection. Radiographs were reviewed independently by two evaluators, and the severity of GHJ OA was categorized (mild, moderate, or severe) using the Samilson–Prieto classification. Results: Fifty-five patients were identified, with a mean age of 43 years (18.6–54.6 years). These cases were classified as being mild in 11 (20%), moderate in 21 (38%), and severe in 23 (42%) using Samilson-Prieto classification. In the severe group, there was a statistically significant improvement in the OSS at all time points. In the moderate group, there were statistically significant improvements at 6 weeks and 12 weeks but not at 6 months. In the mild group, there were no statistically significant changes. Conclusion: In patients under the age of 55 years with moderate-to-severe GHJ OA, there is a significant improvement in the OSS up to 12 weeks after intra-articular injection of hyaluronate, with improvements lasting up to 26 weeks in more severe cases. Hyaluronate is, therefore, a useful treatment option in younger patients and may potentially delay the need for arthroplasty.