EVIDENCE-BASED REVIEW & RECOMMENDATIONS FROM THE BRAZILIAN SOCIETY OF SHOULDER AND ELBOW SURGERY: HYALURONIC ACID VERSUS CORTICOSTEROID INJECTIONS FOR SHOULDER OSTEOARTHRITIS

Abstract

ABSTRACT Introduction: Shoulder osteoarthritis is an inflammatory and degenerative condition affecting the joint between the humeral head and the glenoid. It is estimated to affect up to 20% of patients aged 60 or older. In our setting, the use of hyaluronic acid is becoming increasingly employed for the treatment of shoulder osteoarthritis. Therefore, this consensus aims to review the current literature to determine whether treatment with hyaluronic acid infiltration is more effective than corticosteroid infiltration in terms of pain outcome for the treatment of shoulder osteoarthritis in adults. Methods: A systematic review of the literature was conducted in the Pubmed, Embase, Cochrane Library and BVS databases up to November 2025, aiming to evaluate whether intra-articular injection with hyaluronic acid is more effective than with corticosteroids for the treatment of shoulder osteoarthritis in adults. Results: The systematic review concluded that hyaluronic acid infiltration is more effective than corticosteroid infiltration for pain and function outcomes, mainly after six months post-infiltration. Conclusion: There is evidence, albeit of very low quality, demonstrating that hyaluronic acid injections are more effective than corticosteroid injections for the treatment of shoulder osteoarthritis, with the best results for both treatment modalities occurring in mild to moderate cases of shoulder osteoarthritis. Level of evidence II; Systematic Review.