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Platelet-Rich Plasma Versus Corticosteroid Injection in Patients With Primary Frozen Shoulder: A Single-Blinded
Lin-Fen Hsieh1, Yu-Shan Fu2, Ting-An Chen2
1Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; School of Medicine, Fu Jen Catholic University, New Taipei City.
Objective:
To compare the effects of combined glenohumeral joint and subacromial-subdeltoid bursa injections using platelet-rich plasma (PRP), corticosteroids (CSs), or normal saline, in conjunction with physical therapy (PT), for the treatment of frozen shoulder.
Design:
Prospective, single-blinded, randomized controlled trial.
Setting:
Rehabilitation clinic in a medical center.
Participants:
Ninety patients (N=90) with primary frozen shoulder.
Interventions:
Participants were randomly assigned to 1 of the 3 intervention groups: PRP injection + PT (n=30), CS injection + PT (n=30), and normal saline injection + PT (n=30). Each participant received 2 ultrasound-guided injections targeting both the glenohumeral joint and subacromial-subdeltoid bursa.
Main Outcome Measures:
The primary outcome was the Shoulder Pain and Disability Index. Secondary outcomes included the Shoulder Disability Questionnaire, pain visual analog scale, active and passive range of motion, the 36-Item Short Form Health Survey, and patient self-assessment. Assessments were performed at baseline and at 1, 2, 4, and 6 months after treatment initiation.
Results:
The CS group exhibited significantly greater improvement in Shoulder Pain and Disability Index (P<.001), Shoulder Disability Questionnaire (P<.001), pain visual analog scale during activity (P=.005), active abduction (P=.022), active internal rotation (P=.036), passive abduction (P=.012), passive internal rotation (P=.029), self-assessment (P<.001), and selective 36-Item Short Form Health Survey domains. The therapeutic effect of CS was evident at 1 month and persisted through the 6-month follow-up.
Conclusion:
CS injections yielded superior outcomes compared with PRP, particularly during the freezing stage of frozen shoulder. Nonetheless, all 3 treatment groups exhibited significant postintervention improvement.
