Current Role of Intra-Articular Injections of Platelet-Rich Plasma in Adhesive Capsulitis of Shoulder: A Systematic Review

Bushu Harna; Vijay Gupta; Shivali Arya; Naveen Jeyaraman; Ramya Lakshmi Rajendran; Madhan Jeyaraman; Prakash Gangadaran; Manish Khanna; Chae Moon Hong; Byeong-Cheol Ahn

doi:10.3390/bioengineering10010021

Current Role of Intra-Articular Injections of Platelet-Rich Plasma in Adhesive Capsulitis of Shoulder: A Systematic Review

Bioengineering (Basel). 2022 Dec 22;10(1):21. doi: 10.3390/bioengineering10010021.

Authors

Bushu Harna^{1

2

3}, Vijay Gupta^{1

2

4}, Shivali Arya⁵, Naveen Jeyaraman^{1

2

6}, Ramya Lakshmi Rajendran⁷, Madhan Jeyaraman^{1

2

8}, Prakash Gangadaran^{7

9}, Manish Khanna^{1

2}, Chae Moon Hong⁷, Byeong-Cheol Ahn^{7

9}

Affiliations

¹ Indian Orthoapedic Rheumatology Association (IORA), Lucknow 226010, Uttar Pradesh, India.
² Indian Stem Cell Study Group (ISCSG) Association, Lucknow 226010, Uttar Pradesh, India.
³ Department of Orthopaedics, Max Super Speciality Hospital, Patparganj, New Delhi 110017, India.
⁴ Elite Clinic for Orthopaedics and Critical Care Centre, Delhi Gate Agra 282002, Uttar Pradesh, India.
⁵ Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
⁶ Department of Orthopaedics, Rathimed Speciality Hospital, Chennai 600040, Tamil Nadu, India.
⁷ Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Republic of Korea.
⁸ Department of Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai 600056, Tamil Nadu, India.
⁹ BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, Department of Biomedical Sciences, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea.

Abstract

Adhesive capsulitis shoulder is a common problem of patients presenting with shoulder pain and disability. The approach to such patients includes a variety of modalities. This systematic review evaluates the efficacy of intra-articular injections of platelet-rich plasma (PRP) in the treatment. A literature search was performed between January 2010 and 30 May 2022. MeSH terms used were 'Platelet-rich plasma' OR 'PRP' AND 'Frozen shoulder' OR 'Adhesive capsulitis shoulder' OR 'Periarthritis shoulder'. The search included published articles in the English language involving human subjects. Studies evaluating other types of shoulder disorders, in vitro studies, review articles, animal-model studies, and pre-clinical trials were excluded. The data regarding study characteristics, efficacy, and safety outcomes were analyzed. A total of 11 studies with 347 patients over 10 years were finally included in this review. Most publications were in 2019 and 2020, mostly from India. This review included seven comparative studies, three case series, and one case report. In seven studies, a single intra-articular PRP injection was administered, whereas in the rest of the studies two or multiple injections were given. Only one study demonstrated an equivocal efficacy of PRP and steroid intra-articular injection. The rest all depicted better clinical and functional outcomes with the PRP injection. Only one study compared the outcomes of hydro-dissection treatment in adhesive capsulitis with the intra-articular PRP injection. The rest all either examined PRP alone or compared it with the steroid intra-articular injection. None of the studies showed any major side effects. The intra-articular injections of PRP in the management of adhesive capsulitis of the shoulder provide a new treatment approach. Further studies are required to ascertain the efficacy and safety of the PRP intraarticular injection as a management alternative in adhesive capsulitis.

Keywords: adhesive capsulitis; frozen shoulder; periarthritis shoulder; platelet-rich plasma; steroid.

Publication types

Review

Abstract

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