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Objective: To assess if ultrasound (US)-guided viscosupplementation can reduce pain and improve function in elderly patients with cuff tear arthropathy.Patients and Methods: Ninety-three patients aged over 65 with grade 3 or above cuff tear arthropathy were included in this prospective open-label non-randomized trial. Institutional review board approval and informed consent were obtained. Thirty-three patients received intra-articular injections of sodium hyaluronate under US guidance. Sixty patients constituted the control group. Shoulder joint function was assessed with Constant scores (CS) and pain with a visual analogue scale (VAS).Results: Compared with controls, treated patients reported a significant decrease in symptoms at 1 (mean CS 66±3.1 vs 37±6.9; mean VAS 1.9±1.2 vs 6.9±2.2), 2 (mean CS 65±3.2 vs 35±7.2; mean VAS 1.7±1.2 vs 6.8±2.5), 3 (mean CS 66±3.4 vs 33 6.1; mean VAS 2.3±1.2 vs 6.6±1.9), and 4 (mean CS 62±3.0 vs 34±6.5; mean VAS 3.3±1.4 vs 7.8±3.1) months, p<0.001. After 5 months there were no differences.Conclusion: US-guided viscosupplementation is a beneficial therapeutic option in the first months of treatment. [ABSTRACT FROM AUTHOR]