Efficacy of Platelet-Rich Plasma Injection on Range of Motion, Pain, and Disability in Patients With Adhesive Capsulitis: A Systematic Review and Meta-analysis

Ho-Wei Lin; Ka-Wai Tam; Tsan-Hon Liou; Chi-Lun Rau; Shih-Wei Huang; Tzu-Herng Hsu

doi:10.1016/j.apmr.2023.03.032

Efficacy of Platelet-Rich Plasma Injection on Range of Motion, Pain, and Disability in Patients With Adhesive Capsulitis: A Systematic Review and Meta-analysis

Arch Phys Med Rehabil. 2023 Dec;104(12):2109-2122. doi: 10.1016/j.apmr.2023.03.032. Epub 2023 Apr 28.

Authors

Ho-Wei Lin¹, Ka-Wai Tam², Tsan-Hon Liou³, Chi-Lun Rau³, Shih-Wei Huang³, Tzu-Herng Hsu⁴

Affiliations

¹ School of Medicine, College of Medicine, Taipei Medical University, Taipei City.
² Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Cochrane Taiwan, Taipei Medical University, Taipei City; Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City.
³ Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
⁴ Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan. Electronic address: yourdadwillbeok@hotmail.com.tw.

PMID: 37119955
DOI: 10.1016/j.apmr.2023.03.032

Abstract

Objective: To investigate the therapeutic effects of platelet-rich plasma (PRP) injection on range of motion, pain, and disability in patients with adhesive capsulitis (AC).

Data sources: The authors performed the literature search in the PubMed, Embase, and Cochrane Library databases in February 2023.

Study selection: Prospective studies comparing the outcomes of PRP with other intervention in patients with AC.

Data extraction: The quality of included randomized trials was assessed using the revised Cochrane Risk of Bias (RoB 2.0) tool. The Risk of Bias in Non-Randomized Studies of Interventions tool was applied to assess the quality of nonrandomized trials. The mean difference (MD) or standardized mean difference (SMD) was determined as the effect size for continuous outcomes, and outcome accuracy was determined using 95% confidence intervals (CIs).

Data synthesis: Fourteen studies involving 1139 patients were included. Our meta-analysis revealed that PRP injection can significantly improve passive abduction (MD=3.91; 95% CI, 0.84-6.98), passive flexion (MD=3.90; 95% CI, 0.15-7.84), and disability (SMD=-0.50; 95% CI, -1.29 to -0.74) within 1 month after intervention. Moreover, PRP injection can significantly improve passive abduction (MD=17.19; 95% CI, 12.38-22.01), passive flexion (MD=17.74; 95% CI, 9.89-25.59), passive external rotation (MD=12.95; 95% CI, 10.04-15.87), pain (MD=-8.40; 95% CI, -16.73 to -0.06), and disability (SMD=-1.02; 95% CI, -1.29 to -0.74) 3 months after intervention. PRP injection can also significantly improve pain (MD=-18.98; 95% CI, -24.71 to -13.26), and disability (SMD=-2.01; 95% CI, -3.02 to -1.00) 6 months after intervention. In addition, no adverse effects of PRP injection were reported.

Conclusions: PRP injection may serve as an effective and safe treatment for patients with AC.

Keywords: Bursitis; Pain; Platelet-rich plasma; Range of motion, articular; Rehabilitation.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Bursitis* / therapy
Humans
Platelet-Rich Plasma*
Prospective Studies
Range of Motion, Articular
Shoulder Pain / therapy
Treatment Outcome