Intra-articular injections for shoulder arthritis in adults: a systematic review

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background The management of glenohumeral osteoarthritis (GHOA) is challenging, particularly in patients who are not eligible for surgery. In recent years, several injectable therapies, including hyaluronic acid (HA), corticosteroids (CCs), platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and mesenchymal stem cells (MSCs), have emerged as potential options for managing pain and improving joint function. This systematic review aims to summarise the current evidence on infiltrative strategies to manage GHOA in adults. Methods This review followed the PRISMA 2020 guidelines. PubMed, Web of Science, and Embase were systematically searched in May 2025. All clinical studies investigating infiltrative strategies to manage shoulder arthritis in adults were considered for inclusion. Only studies with a minimum follow-up of six months were included. The methodological quality of the included studies was assessed using the Cochrane RoB2 tool for randomised controlled trials (RCTs) and the ROBINS-I tool for non-randomised studies. Results Data from 1125 patients (1126 shoulders) were analysed. The mean age of the patients was 63.4 ± 5.8 years, and 34.1% (384 of 1125 patients) were women. The most commonly studied intra-articular treatments included HA and CCs. The rate of surgery for persistent symptoms or functional impairment was 3.2% (35 of 1079 reported procedures).

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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