ABSTRACT
Purpose
To evaluate the role of platelet-rich plasma (PRP) for adhesive capsulitis (AC) as
compared to other injectables.
Methods
A literature search was performed on PubMed and Embase online databases identifying
articles evaluating injection therapy for the treatment of AC. Inclusion criteria
included prospective studies comparing PRP against alternative injectables with a
minimum 15 patients in each treatment arm and a minimum 12-week follow-up. Pain scores,
range of motion, and function scores were the primary outcomes assessed.
Results
Five articles met inclusion criteria comparing PRP to corticosteroid or saline injections.
There were 157 patients treated with PRP with follow-up duration ranging from three
to six months. All five studies demonstrated statistically significant improvement
in pain scores, motion, and function scores for patients receiving PRP, corticosteroid,
and saline injections. However, PRP was consistently superior on intergroup analyses
in all but one study. In four studies, pain and function scores favored PRP over control
at final follow-up (range in mean difference for VAS pain score: -2.2 – 0.69, n=5
and SPADI score: -50.5 – -4.0, n=3) while three studies found greater improvement
in shoulder motion after PRP (range in mean difference for forward flexion: 0.7 –
34.3 degrees and external rotation -2.3 – 20.4 degrees, n=4). One study found no significant
difference between PRP and corticosteroid injections, but noted results were comparable.
Conclusions
According to a limited number of prospective studies, PRP injections for AC is at
least equivalent to corticosteroid or saline injections and often leads to improved
pain, motion, and functional outcomes at 3–6-month follow-up. Given the small number
of studies, with design heterogeneity, there is insufficient evidence to routinely
recommend PRP for AC. However, the results are promising and do support considering
PRP as an adjunct treatment option for AC, especially for patients refractory and/or
averse to corticosteroids or alternative treatment modalities.
Key Words
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Article info
Publication history
Accepted:
January 5,
2023
Received in revised form:
January 5,
2023
Received:
June 23,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Acknowledgements
Not applicable
National/International Presentations
The abstract has been presented as a poster at the Orthopedics Today Hawaii 2022 conference and as a podium paper at the American Academy of Orthopaedic Surgeons 2022 Annual Meeting.
Platelet-Rich Plasma for Adhesive Capsulitis
Level of Evidence: Level II, systematic review of level I-II studies
Identification
Copyright
© 2023 Published by Elsevier on behalf of the Arthroscopy Association of North America
