Comparative efficacy of ultrasonically guided infiltration of single shot of platelet-rich plasma and triamcinolone acetonide in adhesive capsulitis of shoulder joint - a prospective clinical study

Abstract

Background: Adhesive capsulitis is also termed periarthritis of the shoulder joint or frozen shoulder. It is the most common cause of pain in and around the shoulder joint, extending up to the insertion of the deltoid muscle in the middle of the arm. The incidence of adhesive capsulitis ranges from 2% to 5%. It is prevalent in the middle-aged (40–60 years) group. Females suffer more from this condition. In the recent past, the infiltration of steroids into the shoulder joint was the mainstay of the treatment. Platelet-rich plasma (PRP) has appeared as a new hope for such patients, as it is believed to enhance the revascularization of the soft tissue and also increase the concentration of growth factors to improve and accelerate tendon healing. Aims and Objectives: This present study was done to evaluate the relative efficacy of ultrasonically guided infiltration of PRP and triamcinolone acetonide. Materials and Methods: The present clinical prospective study was conducted on 50 patients in a tertiary institute in Punjab, India, from June 2018 to December 2020 to evaluate the comparative efficacy of ultrasonically guided infiltration through the posterior approach of PRP and triamcinolone acetonide in the outdoor patient department of the department of orthopedics. The patients selected for the intra-articular infiltration were in their middle age (40–60 years), diagnosed as having adhesive capsulitis with non-resolution of signs and symptoms for the last 12 weeks. Results: PRP was a superior alternative to triamcinolone acetonide in the management of adhesive capsulitis as it resulted in long-term improvement in the visual analog score and disability of arm, shoulder, and hand scores with significant margins. Conclusion: PRP is definitively a newer, effective, cost-effective, autogenously derived alternative to the corticosteroids used till date, as it not only provides a long lasting effect but also helps in regenerative medicine.