Comparative study of efficacy of platelet rich plasma injection versus corticosteroid injection in conservative management of periarthritis shoulder

Sambit Kumar Panda,Rabindra Nayak,Sabyasachi Swain,Surai Soren,Ashok Kumar Nayak

doi:10.18231/j.pjms.2021.056

Abstract

Analysis of eighty patients with periarthritis shoulder was done. Patients were thoroughly evaluated and were divided into two groups in a randomized trial. Forty patients were in group-A who received 3doses of injection of PRP (4ml) 2 weeks apart within a duration of 6weeks. Equal number of patients were in group-B. They received 2ml of Injection corticosteroid 2weeks apart within a duration of 6 weeks. All participants were advised to perform a home-based hot fomentation and 15min exercise therapy. One participant from group A and 2 from group B were lost to follow up. There were 35 male and 42 female who completed the study. Analysis of 77 subjects who completed the study was done. Participant were evaluated for range of motion of shoulder as main outcome measure. Visual Analogue Scale (VAS) and (Quick DASH) was used to measure pain and functions of the shoulder. The evaluation of Participants was done at 0,3,6 and 12 weeks. ANOVA test and Chi-square test, was repeatedly used to measure the differences.Participants who were given PRP injections showed significant improvements in active and passive range of shoulder motion as measured by VAS and Quick DASH over corticosteroid injection. This was also reflected statistically. No major adverse reactions were observed during 12 weeks of intervention.In our study, the injection of PRP showed marked improvement in the range of motion of shoulder over corticosteroid injection but it needs other study to be treatment of choice. It emerged as an option for treatment in diabetes patient and condition where steroid is contraindicated.

Highlights

Periarthritis (PA) shoulder is characterised by pain, stiffness of shoulder joint. 1–3 It limits the movement of shoulder joint
Periarthritis shoulder affects around 2-5% of general population
Corticosteroid, physiotherapy which includes mobilization exercise, ultrasonic therapy, manipulation under general anaesthesia, arthroscopic release of fibrous tissue. 6–8 The ultrasonic therapy produces in consistent results. 9,10 none of the treatment provide complete relief from periarthritis. 11,12 The search for a better treatment is continuing

Summary

Introduction

Periarthritis (PA) shoulder is characterised by pain, stiffness of shoulder joint. 1–3 It limits the movement of shoulder joint. Periarthritis (PA) shoulder is characterised by pain, stiffness of shoulder joint. Periarthritis shoulder affects around 2-5% of general population. As our country is a diabetic capital of the world the incidence may be much higher. 4,5 There are various methods of treatment for periarthritis like intra-articular injection of hyalauronic acid and corticosteroid, physiotherapy which includes mobilization exercise, ultrasonic therapy, manipulation under general anaesthesia, arthroscopic release of fibrous tissue. 9,10 none of the treatment provide complete relief from periarthritis. In that respect PRP is a promising treatment. PRP is extracted from patients own blood. It contains higher concentration of platelets above the baseline. 13,14 Along with higher platelet concentration it has higher growth factors and anti-inflammatory agents which promotes to reduce healing time and inflammation.

Methods

Results

Conclusion