Harna Bushu, Gupta Vijay, Arya Shivali, Jeyaraman Naveen, Rajendran Ramya Lakshmi, Jeyaraman Madhan, Gangadaran Prakash, Khanna Manish, Hong Chae Moon, Ahn Byeong-Cheol
Indian Orthoapedic Rheumatology Association (IORA), Lucknow 226010, Uttar Pradesh, India.
Indian Stem Cell Study Group (ISCSG) Association, Lucknow 226010, Uttar Pradesh, India.
Bioengineering (Basel). 2022 Dec 22;10(1):21. doi: 10.3390/bioengineering10010021.
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.
粘连性肩关节囊炎是出现肩部疼痛和功能障碍的患者的常见问题。针对这类患者的治疗方法包括多种方式。本系统评价评估关节腔内注射富血小板血浆（PRP）在治疗中的疗效。于2010年1月至2022年5月30日进行了文献检索。使用的医学主题词为“富血小板血浆”或“PRP”以及“肩周炎”或“粘连性肩关节囊炎”或“肩关节周围炎”。检索包括以英文发表的涉及人类受试者的文章。排除了评估其他类型肩部疾病的研究、体外研究、综述文章、动物模型研究和临床前试验。对有关研究特征、疗效和安全性结果的数据进行了分析。本评价最终纳入了11项研究，共347例患者，时间跨度超过10年。大多数出版物发表于2019年和2020年，大多来自印度。本评价包括7项比较研究、3个病例系列和1篇病例报告。在7项研究中，进行了单次关节腔内PRP注射，而在其余研究中进行了两次或多次注射。只有1项研究表明PRP与关节腔内注射类固醇的疗效不明确。其余所有研究均表明PRP注射具有更好的临床和功能结果。只有1项研究比较了粘连性肩关节囊炎的水分离治疗与关节腔内PRP注射的结果。其余所有研究要么单独研究PRP，要么将其与关节腔内注射类固醇进行比较。没有研究显示任何严重副作用。关节腔内注射PRP治疗粘连性肩关节囊炎提供了一种新的治疗方法。需要进一步研究以确定PRP关节腔内注射作为粘连性肩关节囊炎治疗替代方法的疗效和安全性。
