Efficacy of high molecular weight sodium hyaluronate in frozen shoulder in diabetes mellitus type 2 patients: A randomized controlled study.

Aims and Objectives: (1). To assess the efficacy of intra-articular injection of high molecular weight sodium hyaluronate (SH) on functional outcome in frozen shoulder in diabetes mellitus (DM) type 2 patients, and (2). To compare it with the efficacy of corticosteroid (methylprednisolone). Materials and Methods: This prospective, double blind, RCT included 67 patients. They were randomized in two groups: Group-A (methyl-prednisolone) and Group-B (SH). Three-weekly intra-articular injections of respective drugs (preceded by intra-articular injection of xylocaine as local anesthetic) were given by posterior technique under ultrasound guidance. Sixty-one patients completed treatment and follow-up. Quick DASH score, total shoulder flexion, and total shoulder abduction (passive) were used for assessment of outcome. Follow-up period was 6 months. Result and Conclusion: Both SH and corticosteroid caused significant improvement in shoulder function beginning within 1 week and lasting for at least 6 months. No significant adverse effects were observed in SH group. Corticosteroid group had 10% incidence of moderate to severe pain in GH joint lasting 12-24 hours. Intra-articular corticosteroid has known adverse effects like worsened glycemic control, osteoporosis, tendon rupture, and decreased immunity at local site. Hence, we suggest that SH may be used as an alternative drug to popular steroid use for the patients of frozen shoulder in DM type 2. [ABSTRACT FROM AUTHOR]