Journal on Recent Advances in Pain

Register      Login

VOLUME 6 , ISSUE 1 ( January-April, 2020 ) > List of Articles

ORIGINAL RESEARCH

Ongoing Efficacy of Platelet-rich Plasma vs Corticosteroid Injection in Patients with Adhesive Capsulitis: A Prospective Randomized Assessor-blind Comparative Analysis

Sachin Upadhyay, Kailash Jorule, Hashmukh S Varma, Mayank Chansoria

Keywords : Adhesive capsulitis, Corticosteroid, Platelet-rich plasma, Shoulder pain and disability index

Citation Information : Upadhyay S, Jorule K, Varma HS, Chansoria M. Ongoing Efficacy of Platelet-rich Plasma vs Corticosteroid Injection in Patients with Adhesive Capsulitis: A Prospective Randomized Assessor-blind Comparative Analysis. J Recent Adv Pain 2020; 6 (1):10-16.

DOI: 10.5005/jp-journals-10046-0160

License: CC BY-NC 4.0

Published Online: 25-08-2013

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Introduction: The primary objective of the present study was to assess the safety and efficacy of platelet-rich plasma (PRP) injections for management of adhesive capsulitis and compare the clinical outcome with injection of corticosteroid. Materials and methods: A total of 120 patients were randomized into PRP (group I) or steroid (group II) group. Patients were assigned to receive a single injection of 1% lidocaine with either methylprednisolone (steroid) or PRP. All patients were assessed at 1, 3, and 6 months after the index procedure. The shoulder pain and disability index (SPADI) was used to evaluate the clinical results. Data were analyzed with a paired t test. The level of significance was considered as p < 0.05. Results: The efficiency of PRP injection was better and sustained than steroid. In PRP group, mean pain scale, mean disability, and total SPADI scores were almost linearly improved, while the scores increased to a higher level at the final follow-up visit compared with that post 1 and 3 months in the steroid group (p < 0.05). No major adverse complications were noted. Conclusion: In the current randomized, single-center, prospective preliminary study, results indicate that treating adhesive capsulitis with PRP injections is safe and has the potential to reduce pain and improve the functional outcome. The PRP injection had a more prolonged efficiency than steroid injections. Clinical significance: The PRP injections are safe and valuable therapeutic modality to alleviate the symptoms in subjects with adhesive capsulitis of shoulder.


PDF Share
  1. Le HV, Lee SJ, Nazarian A, et al. Adhesive capsulitis of the shoulder: Review of pathophysiology and current clinical treatments. Shoulder Elbow 2017;9(2):75–84. DOI: 10.1177/1758573216676786.
  2. Neviaser JS. Adhesive capsulitis of the shoulder: a study of the pathological findings in periarthritis of the shoulder. J Bone Joint Surg 1945;27:211–222.
  3. Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med 2008;1(3-4):180–189. DOI: 10.1007/s12178-008-9031-6.
  4. Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. The Cochrane database System Rev 2003;2003(1):CD004016. DOI: 10.1002/14651858.CD004016.
  5. Wang W, Shi M, Zhou C. Effectiveness of corticosteroid injections in adhesive capsulitis of shoulder: a meta-analysis. Medicine 2017;96(28):e7529. DOI: 10.1097/MD.0000000000007529.
  6. Kothari SY, Srikumar V, Singh N. Comparative efficacy of platelet rich plasma injection, corticosteroid injection and ultrasonic therapy in the treatment of periarthritis shoulder. J Clin Diagn Res 2017;11(5):RC15–RC18. DOI: 10.7860/JCDR/2017/17060.9895.
  7. Aslani H, Nourbakhsh ST, Zafarani Z, et al. Platelet-Rich Plasma for Frozen Shoulder: A Case Report. Arch Bone Jt Surg 2016;4(1):90–93.
  8. Lin J. Platelet-rich plasma injection in the treatment of frozen shoulder: a randomized controlled trial with 6-month follow-up. Int J Clin Pharmacol Ther 2018;56(8):366–371. DOI: 10.5414/CP203262.
  9. Barman A, Mukherjee S, Sahoo J, et al. Single intra-articular platelet-rich plasma versus corticosteroid injections in the treatment of adhesive capsulitis of the shoulder: a cohort study. Am J Phys Med Rehabil 2019;98(7):549–557. DOI: 10.1097/PHM.0000000000001144.
  10. Upadhyay S, Varma HS, Yadav S. Potential therapeutic effects of autologous platelet rich plasma on impaired wound healing: a prospective clinical study. Int J Res Orthop 2018;4(6):820–825. DOI: 10.18203/issn.2455-4510.IntJResOrthop20184024.
  11. Upadhyay S, Damor V. Autologous platelet rich plasma versus corticosteroid injection for chronic plantar fasciitis: a prospective controlled randomized comparative clinical study. Int J Res Med Sci 2018;6(5):1594–1599. DOI: 10.18203/2320-6012.ijrms20181430.
  12. Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ 2005;331(7530):1453–1456. DOI: 10.1136/bmj.331.7530.1453.
  13. Chauhan S, Kothari SY, Laisram N. Comparison of ultrasonic therapy, sodium hyaluronate injection and steroid injection in the treatment of periarthritis shoulder. IJPMR 2012;23(3):105–110.
  14. Bulgen DY, Binder AL, Hazleman BL, et al. Frozen shoulder: Prospective clinical study with an evaluation of three treatment regimens. Ann Rheum Dis 1984;43(3):353–360. DOI: 10.1136/ard.43.3.353.
  15. MacMahon PJ, Eustace SJ, Kavanagh EC. Injectable corticosteroid and local anesthetic preparations: a review for radiologists. Radiology 2009;252(3):647–661. DOI: 10.1148/radiol.2523081929.
  16. Hand C, Clipsham K, Rees JL, et al. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg 2008;17(2):231–236. DOI: 10.1016/j.jse.2007.05.009.
  17. Levine WN, Kashyap CP, Bak SF, et al. Nonoperative management of idiopathic adhesive capsulitis. J Shoulder Elbow Surg 2007;16(5):569–573. DOI: 10.1016/j.jse.2006.12.007.
  18. Murakami AM, Kompel AJ, Engebretsen L, et al. The epidemiology of MRI detected shoulder injuries in athletes participating in the Rio de Janeiro 2016 summer olympics. BMC Musculoskelet Disord 2018;19(1):296. DOI: 10.1186/s12891-018-2224-2.
  19. Kingston K, Curry EJ, Galvin JW, et al. Shoulder adhesive capsulitis: epidemiology and predictors of surgery. J Shoulder Elbow Surg 2018;27(8):1437–1443. DOI: 10.1016/j.jse.2018.04.004.
  20. Yoon SH, Lee HY, Lee HJ, et al. Optimal dose of intra-articular corticosteroids for adhesive capsulitis: a randomized, triple-blind, placebo-controlled trial. Am J Sports Med 2013;41(5):1133–1139. DOI: 10.1177/0363546513480475.
  21. Dacre JE, Beeney N, Scott DL. Injections and physiotherapy for the painful stiff shoulder. Ann Rheum Dis 1989;48(4):322–325. DOI: 10.1136/ard.48.4.322.
  22. Zhang J, Wang JH. PRP treatment effects on degenerative tendinopathy – an in vitro model study. Muscles Ligaments Tendons J 2014;4(1):10–17. DOI: 10.32098/mltj.01.2014.03.
  23. Sheth U, Dwyer T, Smith I, et al. Does platelet-rich plasma lead to earlier return to sport when compared with conservative treatment in acute muscle injuries? A systematic review and meta-analysis. Arthroscopy 2018;34(1):281–288.e281. DOI: 10.1016/j.arthro.2017.06.039.
  24. Ebert JR, Wang A, Smith A, et al. A midterm evaluation of postoperative platelet-rich plasma injections on arthroscopic supraspinatus repair: a randomized controlled trial. Am J Sports Med 2017;45(13):2965–2974. DOI: 10.1177/0363546517719048.
  25. Molloy T, Wang Y, Murrell G. The roles of growth factors in tendon and ligament healing. Sports Med 2003;33(5):381–394. DOI: 10.2165/00007256-200333050-00004.
  26. Badade PS, Mahale SA, Panjwani AA, et al. Antimicrobial effect of platelet-rich plasma and platelet-rich fibrin. Indian J Dent Res 2016;27(3):300–304.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.