A COMPARATIVE STUDY OF EFFICACY OF INTRA ARTICULAR STEROID VS. PLATELET RICH PLASMA INJECTION IN ADHESIVE CAPSULITIS.

Subhasish Pati, Joyshree Panda, Rajesh Pramanik

Abstract


Introduction: Adhesive capsulitis is one of the major causes of restriction of movement and pain in shoulder joint. Over the years the efficacy of steroid injections to relieve pain and improve range of motion was well established. Platelet Rich Plasma (PRP) has few more properties in management of same and hence the study aims to show PRP as an alternative to steroids.

Aim: To look for improvement in VAS, Range of Motion and SPADI due to PRP and steroids and to compare their efficacies.

Materials and method: Two groups of Patients with adhesive capsulitis of shoulder were randomly selected. Group A (n=20) was injected with PRP and Group B (n=20) with methyl Prednisolone in aseptic technique after verbal consent. Assessment was done before the block then after 1st week, 4th week and 3months after the block.

Results: Statistically significant improvement was seen in both the groups with long term   improvement better with PRP.

Conclusion: Although steroid showed better results in immediate reduction of pain compared to PRP but in long term follow up PRP was superior.


Keywords


Adhesive capsulitis, Intra- articular injection,PRP, Steroid.

Full Text:

PDF

References


. Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow. 2017 Apr;9(2):75-84.

. Pal B, Anderson J, Dick WC, Griffiths ID. Limitation of joint mobility and shoulder capsulitis in insulin-and non-insulin-dependent diabetes mellitus. Rheumatology. 1986 May 1;25(2):147-51.

. MORÉN‐HYBBINETTE IN, MORITZ U, SCHERSTÉN B. The clinical picture of the painful diabetic shoulder—natural history, social consequences and analysis of concomitant hand syndrome. Acta Medica Scandinavica. 1987 Jan 12;221(1):73-82.

. Neviaser AS, Neviaser RJ. Adhesive capsulitis of the shoulder. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2011 Sep 1;19(9):536-42.

. Dias R, Cutts S, Massoud S. Frozen shoulder. Bmj. 2005 Dec 15;331(7530):1453-6.

. Kothari SY, Venkataraman Srikumar NS. Comparative efficacy of platelet rich plasma injection, corticosteroid injection and ultrasonic therapy in the treatment of periarthritis shoulder. Journal of Clinical and Diagnostic Research: JCDR. 2017 May;11(5):RC15.

. Mishra A, Woodall Jr J, Vieira A. Treatment of tendon and muscle using platelet-rich plasma. Clinics in sports medicine. 2009 Jan 1;28(1):113-25.

. Amable PR, Carias RB, Teixeira MV, da Cruz Pacheco Í, do Amaral RJ, Granjeiro JM, Borojevic R. Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem cell research & therapy. 2013 Sep 1;4(3):67.

. Cruess RL. Steroid-induced avascular necrosis of the head of the humerus. Natural history and management. The Journal of bone and joint surgery. British volume. 1976 Aug;58(3):313-7.

. Saif DS, Serag DM, El Tabl MA. Comparative study between platelet-rich plasma injection and steroid injection in mild–moderate shoulder osteoarthritis and their relation to quality of life. Egyptian Rheumatology and Rehabilitation. 2019 Jan 1;46(1):55.

. Wang W, Shi M, Zhou C, Shi Z, Cai X, Lin T, Yan S. Effectiveness of corticosteroid injections in adhesive capsulitis of shoulder: A meta-analysis. Medicine. 2017 Jul;96(28).

. Jacobs LG, Smith MG, Khan SA, Smith K, Joshi M. Manipulation or intra-articular steroids in the management of adhesive capsulitis of the shoulder? A prospective randomized trial. Journal of shoulder and elbow surgery. 2009 May 1;18(3):348-53.

. Carette S, Moffet H, Tardif J, Bessette L, Morin F, Frémont P, Bykerk V, Thorne C, Bell M, Bensen W, Blanchette C. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: A placebo‐controlled trial. Arthritis & rheumatism. 2003 Mar;48(3):829-38.


Refbacks

  • There are currently no refbacks.