Effectiveness and safety of ultrasound-guided subacromial hyaluronic acid injections for chronic supraspinatus tendinopathy: A prospective study

Rotator cuff tendinopathy, particularly involving the supraspinatus tendon, is a common cause of shoulder pain and dysfunction. While hyaluronic acid (HA) has shown promise for tendinopathies, its optimal application and long-term efficacy for supraspinatus tendinopathy (ST) remain underexplored. This study aimed to evaluate the effectiveness and safety of ultrasound-guided HA injections in patients with chronic ST. This prospective study recruited 32 patients with chronic ST between August 2022 and August 2023. Patients received two ultrasound-guided subacromial injections of HA one week apart. Outcomes included pain intensity based on Visual Analog Scale (VAS), shoulder function based on Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley Score (CMS), and range of motion (ROM), assessed at various time points up to 12 months. Factors associated with outcome improvement were analyzed using linear regression. Mean VAS, DASH, and CMS scores, along with shoulder ROM, significantly improved from baseline, stabilizing from 3 months post-injection through 12 months. Mean VAS decreased to below 1.4, mean CMS approached 87, and mean DASH fell below 13. No local or systemic complications were observed. Ultrasound-guided subacromial HA injection could be a safe and potentially effective treatment for chronic ST, leading to significant and sustained improvements in pain and shoulder function. These findings support HA as a valuable therapeutic option for chronic ST. Further trials are required to establish optimal injection protocols.