Department of Physical Medicine and Rehabilitation, Ege University Medical School, Bornova, 35100, İzmir, Turkey.
Int Orthop. 2021 Jan;45(1):181-190. doi: 10.1007/s00264-020-04518-9. Epub 2020 Nov 18.
The goal of this study is to investigate whether platelet-rich plasma (PRP) injections are effective in the management of adhesive capsulitis of the shoulder (AC). A triple-blind, randomized controlled trial was designed and conducted in a medical school hospital.
32 adult patients with adhesive capsulitis (21 female, 11 male with a mean age of 57, ranging from 23 to 70) were included in this study. Patients had to have shoulder pain and restrictions in movements (at least 25% when compared to the other side, and at least in two directions) for three months minimum and nine months maximum. Patients were randomized to two groups, and one group took PRP injections for three times every two weeks, while the other group took saline injections in same frequency and volume. A standardized exercise program was also applied to all patients. Patients were evaluated with Shoulder Pain and Disability Index (SPADI), Visual Analogue Scales for pain and disability, ranges of movements, and use of analgesics in before, after, and third month after the initiation of the therapy.
Baseline comparisons between groups showed no differences. SPADI and ranges of motion in all directions showed significant improvements with therapy, and the group which took PRP injections showed better improvements when compared to the control group (p < 0.05). Visual Analogue Scale was found to be better for the PRP group after therapy and third month, and not for the control group (0.4 ± 1.06 and 0.17 ± 0.72 vs. 2.5 ± 2.6 and 2 ± 2.2, respectively, p < 0.05). Use of analgesics was not found to be significant for both groups (p > 0.05).
PRP injections were found to be effective in both pain and disability, and showed improvements in a restricted shoulder due to adhesive capsulitis. These findings might point out PRP as a therapeutic option in the management of adhesive capsulitis.
本研究旨在探讨富血小板血浆（PRP）注射治疗肩粘连性囊炎（AC）的效果。采用三盲、随机对照试验设计，在一所医学院附属医院进行。
本研究纳入 32 例粘连性囊炎患者（21 例女性，11 例男性，平均年龄 57 岁，年龄 23-70 岁）。患者须有肩部疼痛和运动受限（与对侧相比至少 25%，且至少在两个方向上）至少 3 个月，最长 9 个月。患者随机分为两组，一组接受 PRP 注射，每 2 周 3 次，另一组以相同频率和体积接受生理盐水注射。所有患者均接受标准化运动方案。治疗前、治疗后和治疗后 3 个月，采用肩痛和残疾指数（SPADI）、疼痛和残疾视觉模拟量表、活动范围以及镇痛药使用情况评估患者。
组间基线比较无差异。所有方向的 SPADI 和活动范围均随治疗而显著改善，PRP 组改善优于对照组（p<0.05）。治疗后和治疗后 3 个月，PRP 组视觉模拟量表评分优于对照组（0.4±1.06 和 0.17±0.72 与 2.5±2.6 和 2.0±2.2，均 p<0.05）。两组镇痛药使用均无显著差异（p>0.05）。
PRP 注射治疗肩粘连性囊炎疼痛和残疾均有效，可改善粘连性囊炎所致受限肩部的活动度。这些发现可能表明 PRP 是粘连性囊炎治疗的一种治疗选择。
