Chenzhou No. 1 People's Hospital, Chenzhou, Hunan, China.
The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
J Back Musculoskelet Rehabil. 2023;36(3):551-564. doi: 10.3233/BMR-220034.
Frozen shoulder (FS) is characterized by progressive shoulder pain and a limited range of motion. Recently, platelet-rich plasma (PRP) injection is a newly developed treatment option for patients with FS and its efficacy needs to be examined.
By conducting a systematic review and meta-analysis, this study attempted to evaluate the efficacy of PRP injection in the treatment of patients with FS.
PubMed, EMBASE, Web of Science, Elsevier, The Cochrane Library, WanFang Data and CNKI databases were searched up to May 31, 2020. This study included randomized controlled trials as well as prospective cohort studies. Two reviewers independently screened the title, abstract and full text in order to extract data from qualified studies. The main outcome was pain visual analogue score (VAS) while the secondary outcome was range of motion (ROM) of the shoulder joint that consists of four parts: internal rotation, flexion, external rotation and abduction.
Three randomized controlled trials and one prospective cohort study met the inclusion criteria. Accordingly, a total of 359 cases were analyzed and followed up to 3 months. The control group included corticosteroids (CS), ultrasound therapy, and stellate ganglion block. Compared to other groups, VAS was statistically significant after 1 month and 3 months of treatment (SMD: -0.46, 95% CI: -0.75 to -0.18, P= 0.002; I=2 43.2%), (SMD: -0.87, 95% CI: -1.23 to -0.50, P= 0.00, I=2 61.9%). Compared to the control group, only flexion of the patients treated with PRP demonstrated no significant improvement at 1 month, whereas internal rotation, flexion, external rotation and abduction of the shoulder were found to be improved following 3 months of treatment.
The corresponding findings illustrate that compared to other non-operative treatments, local injection of PRP can effectively improve pain and shoulder motion in patients with FS. However, due to the short follow-up time and limitations regarding the quantity and quality of studies, the above conclusions require further elucidation by performing additional high-quality studies.
冻结肩（FS）的特征是进行性肩部疼痛和运动范围受限。最近，富血小板血浆（PRP）注射是一种新开发的 FS 患者治疗选择，需要对其疗效进行检查。
通过系统评价和荟萃分析，本研究试图评估 PRP 注射治疗 FS 患者的疗效。
检索 PubMed、EMBASE、Web of Science、Elsevier、The Cochrane Library、万方数据和中国知网数据库，截至 2020 年 5 月 31 日。本研究包括随机对照试验和前瞻性队列研究。两名评审员独立筛选标题、摘要和全文，以从合格研究中提取数据。主要结果是疼痛视觉模拟评分（VAS），次要结果是肩关节活动度（ROM），包括四个部分：内旋、前屈、外旋和外展。
符合纳入标准的有 3 项随机对照试验和 1 项前瞻性队列研究。因此，共分析了 359 例并随访了 3 个月。对照组包括皮质类固醇（CS）、超声治疗和星状神经节阻滞。与其他组相比，治疗 1 个月和 3 个月后 VAS 具有统计学意义（SMD：-0.46，95%CI：-0.75 至-0.18，P=0.002；I²=243.2%），（SMD：-0.87，95%CI：-1.23 至-0.50，P=0.00，I²=261.9%）。与对照组相比，只有 PRP 治疗组患者的前屈在 1 个月时没有明显改善，而在治疗 3 个月后，肩关节的内旋、前屈、外旋和外展得到改善。
相应的发现表明，与其他非手术治疗相比，PRP 局部注射可有效改善 FS 患者的疼痛和肩部运动。但是，由于随访时间短，并且研究的数量和质量存在局限性，因此需要进一步开展高质量研究来阐明上述结论。
