Effects of platelet-rich plasma injection on pain, range of motion, and disability in adhesive capsulitis: A prospective, randomized-controlled study

Objectives In this study, we aimed to investigate the effectiveness of intra-articular platelet-rich plasma (PRP) injection in adhesive capsulitis. Patients and methods Between January 2019 and December 2019, a total of 40 patients (21 males, 19 females; mean age: 57.1±6.5 years; range, 44 to 72 years) with idiopathic adhesive capsulitis were included. The patients were randomly assigned into two equal groups as the PRP and the control group. The PRP group received two doses of PRP via intra-articular route biweekly under ultrasound guidance. No injection was performed to the control group. In both groups, stretching and Codman exercises were applied as a home- based program. The Visual Analog Scale (VAS), range of motion (ROM), and Shoulder Pain and Disability Index (SPADI) scores were evaluated before the treatment and at 2, 6 and 12 weeks after the treatment. Results There were significant differences in all VAS, SPADI, and ROM scores at all time points after treatment compared to baseline in both groups. At the end of the study, there were significant differences in the active flexion, passive flexion, active abduction, passive abduction, and active external rotation scores at 12 weeks between the groups (p=0.012, p=0.015, p=0.008, p=0.019, and p=0.040, respectively). No significant difference was observed between the groups in terms of VAS and SPADI scores and the other parameters (active and passive extension, active and passive internal rotation, passive external rotation) at 2, 6, and 12 weeks (p>0.05). Conclusion The addition of PRP to exercise treatment can improve patients' joint mobility, but not pain and disability in patients with adhesive capsulitis.

[1]  S. Bouaicha,et al.  A large-scale assessment of the healthcare burden of adhesive capsulitis of the shoulder joint. , 2020, Swiss medical weekly.

[2]  Rob van der Straaten,et al.  Assessment of Scapulothoracic, Glenohumeral, and Elbow Motion in Adhesive Capsulitis by Means of Inertial Sensor Technology: A Within-Session, Intra-Operator and Inter-Operator Reliability and Agreement Study , 2020, Sensors.

[3]  J. C. Cardoso,et al.  Platelet-Rich Plasma and Corticosteroid in the Treatment of Rotator Cuff Impingement Syndrome: Randomized Clinical Trial * , 2019, Revista Brasileira de Ortopedia.

[4]  Sujit Kumar Tripathy,et al.  Single Intra-articular Platelet-Rich Plasma Versus Corticosteroid Injections in the Treatment of Adhesive Capsulitis of the Shoulder , 2019, American journal of physical medicine & rehabilitation.

[5]  J. Cook,et al.  Current trends in tendinopathy management. , 2019, Best practice & research. Clinical rheumatology.

[6]  R. Angelo Surgical Management of Proximal Long Head Biceps Tendon Disorders. , 2018, Sports medicine and arthroscopy review.

[7]  Junhong Lin Platelet-rich plasma injection in the treatment of frozen shoulder: A randomized controlled trial with 6-month follow-up
. , 2018, International journal of clinical pharmacology and therapeutics.

[8]  Ç. Karakükçü,et al.  Comparison of Effects of Leukocyte-Rich and Leukocyte-Poor Platelet-Rich Plasma on Pain and Functionality in Patients With Lateral Epicondylitis. , 2018, Archives of rheumatology.

[9]  O. Mei-Dan,et al.  PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies , 2017, Cartilage.

[10]  Joseph P DeAngelis,et al.  Corticosteroid Injections for Adhesive Capsulitis: A Review , 2017, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[11]  A. Nazarian,et al.  Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments , 2017, Shoulder & elbow.

[12]  K. H. Koh,et al.  Corticosteroid injection for adhesive capsulitis in primary care: a systematic review of randomised clinical trials. , 2016, Singapore medical journal.

[13]  Z. Zafarani,et al.  Platelet-Rich Plasma for Frozen Shoulder: A Case Report. , 2016, The archives of bone and joint surgery.

[14]  D. Connell,et al.  Ultrasound-guided platelet-rich plasma injection for distal biceps tendinopathy , 2015, Shoulder & elbow.

[15]  J. Newman,et al.  Glenohumeral Corticosteroid Injections in Adhesive Capsulitis: A Systematic Search and Review , 2014, PM & R : the journal of injury, function, and rehabilitation.

[16]  N. Marwaha,et al.  Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis , 2013, The American journal of sports medicine.

[17]  B. Yılmaz,et al.  Plateletten zengin plazma uygulamaları , 2013 .

[18]  G. Abrams,et al.  Hyaluronic Acid and Platelet-Rich Plasma, Intra-articular Infiltration in the Treatment of Gonarthrosis: Letter to the Editor , 2013, The American journal of sports medicine.

[19]  W. Hsu,et al.  Addition of intra-articular hyaluronate injection to physical therapy program produces no extra benefits in patients with adhesive capsulitis of the shoulder: a randomized controlled trial. , 2012, Archives of physical medicine and rehabilitation.

[20]  Kyung Min Park,et al.  Platelet-rich plasma loaded hydrogel scaffold enhances chondrogenic differentiation and maturation with up-regulation of CB1 and CB2. , 2012, Journal of controlled release : official journal of the Controlled Release Society.

[21]  R. Arciero,et al.  Platelet-rich plasma differs according to preparation method and human variability. , 2012, The Journal of bone and joint surgery. American volume.

[22]  M. Marcacci,et al.  Use of platelet-rich plasma for the treatment of refractory jumper’s knee , 2010, International Orthopaedics.

[23]  E. Tonga,et al.  The Shoulder Pain and Disability Index (SPADI): Cross-cultural adaptation, reliability, and validity of the Turkish version , 2008 .

[24]  H. Çalış,et al.  Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? , 2006, Rheumatology International.

[25]  Subir Ghosh,et al.  Nonparametric Analysis of Longitudinal Data in Factorial Experiments , 2003, Technometrics.

[26]  Edgar Brunner,et al.  Nonparametric analysis of longitudinal data in factorial experiments , 2012 .

[27]  K. Roach,et al.  Development of a shoulder pain and disability index. , 1991, Arthritis care and research : the official journal of the Arthritis Health Professions Association.