Platelet-Rich Plasma for Adhesive Capsulitis: A Systematic Review

Area of Science:

• Orthopedics
• Regenerative Medicine
• Sports Medicine

Background:

• Adhesive capsulitis (AC), or frozen shoulder, is a prevalent condition causing significant shoulder pain and restricted mobility.
• Platelet-rich plasma (PRP) therapy, utilizing blood concentrate rich in platelets, is explored for its potential to modulate inflammation and promote healing in AC.
• Existing literature requires synthesis to evaluate PRP's efficacy in improving both objective and subjective outcomes for AC patients.

Purpose of the Study:

• To systematically analyze the impact of platelet-rich plasma (PRP) injections on shoulder range of motion (ROM) in patients with adhesive capsulitis (AC).
• To assess the effectiveness of PRP in improving subjective patient outcomes, including pain (visual analog scale - VAS) and functional scores (Disability of Arm, Shoulder, and Hand - DASH; Shoulder Pain and Disability Index - SPADI).

Main Methods:

• A systematic literature search was conducted across PubMed, Embase, and Cochrane databases.
• Studies were screened and selected based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PICOS criteria.
• Data extraction focused on range of motion (ROM) and validated subjective outcome scores (VAS, DASH, SPADI) from included articles.

Main Results:

• Nineteen studies were included, with 11 reporting objective ROM data.
• All studies indicated improved ROM post-PRP injection compared to baseline.
• PRP groups demonstrated significantly greater final ROM (93% of comparisons) and superior VAS, DASH, and SPADI scores compared to control groups.

Conclusions:

• PRP injections represent a highly effective treatment modality for adhesive capsulitis.
• PRP therapy leads to substantial improvements in both objective shoulder range of motion and subjective pain and functional disability.
• The findings support the use of PRP as a valuable therapeutic option for managing frozen shoulder syndrome.