Functional outcome of intra-articular platelet-rich plasma in periarthritis shoulder

Abstract

BACKGROUND: The annual incidence of periarthritis shoulder is between 3% and 5% among general population and as high as 20% among individuals with diabetes. A variety of treatment modalities have been advised but best modality of treatment is subjected to debate. Intra-articular injection of platelet-rich plasma (PRP) is an emerging treatment option and its efficacy needs to be examined and hence the study was conducted. MATERIALS AND METHODS: This prospective analytical study on 46 cases with frozen shoulder was conducted in the Department of Orthopedics, R L Jalappa Hospital, Kolar. The patients were injected intraarticularly with PRP with posterior approach. Patients were assessed at 3, 6, and 12 weeks. Outcome measures, visual analog scale (VAS) score for pain, and QuickDASH for functional ability were measured. RESULTS: Of 46 patients, 21 were men and 25 were women. Mean age of patients was 51 years. Nondominant shoulder was affected in 27 and dominant shoulder in 19 patients. Eleven patients had diabetes mellitus. Mean active abduction improved from the baseline of 65.1° to 133.04°, mean active flexion improved from 82.6° to 147.28°, mean active external rotation improved from 25.3° to 70.02°, and mean active internal rotation improved from 18.91° to 68.58° at the end of 6 weeks’ follow-up. VAS score improved from 6.19 to 1.84 at 12 weeks post-procedure. Functional ability assessed with QuickDASH score showed improvement with successive follow-ups from 81.5 to 22.9. Approximately 52.2% of study patients had excellent results, and 43.5% and 4.3% of patients had good and fair results, respectively. CONCLUSION: In this study, single injection of PRP resulted in significant improvement in range of motion of shoulder, pain, and function with long-term effects. Under total aseptic precautions, when performed with a right technique it has no side effects. This study observes that PRP injection is a reliable, productive, efficient, and safe mode of treatment in periarthritis of shoulder.