Background
Periarthritis or
frozen shoulder, also called
adhesive capsulitis, is characterized by stiffness and
pain along with gradual loss of active and passive movement in the glenohumeral joint. More than 2-5% of the population suffers from
periarthritis with a higher incidence in the age group of 40-60 years. The various treatment modalities used for its management include simple physiotherapy,
short-wave therapy,
ultrasonic therapy,
transcutaneous electrical nerve stimulation,
hydrotherapy,
analgesics,
intra-articular injections, manipulation under
general anesthesia (MUA), and surgical management. The application of intra-articular
steroid injection has been a common and efficacious option in rapidly diminishing
shoulder pain and disability. Some recent studies reported a better outcome using platelet-rich plasma (PRP)
injections in
frozen shoulder cases. Hence, this randomized controlled trial was conducted to compare the efficacy of
intra-articular injections of PRP and
triamcinolone in patients of shoulder
periarthritis in a population from the eastern region of India Methodology A total of 60 patients with
periarthritis shoulder were allocated into two groups after randomization. Group A received 2 mL autologous PRP, and Group B received 2 mL of
triamcinolone (40 mg/mL)
intra-articular injection. Patients were followed up on the 4th week, 12th week, and 24th week. The assessment of
pain and function using the visual analog scale (VAS) score and the Disabilities of Arm, Shoulder, and Hand (DASH) score, respectively, was done at each follow-up. The primary analyses of both primary and secondary outcomes were conducted in the intention-to-treat (ITT) population. SPSS version 24 (IBM Corp., Armonk, NY, USA) was used for data analysis. Results The mean VAS score in the PRP and
triamcinolone groups was 14.33 ± 3.79 and 31.63 ± 7.62, respectively (p = 0.0001) after 24 weeks. The mean DASH score in the PRP and
triamcinolone groups was 18.08 ± 8.08 and 31.76 ± 3.63, respectively (p = 0.0001), which shows significant improvement in both
pain and disability scores in the PRP group after 24 weeks. Conclusions The
triamcinolone group showed better short-term outcomes whereas PRP showed better long-term outcomes in reducing
pain and disability scores in terms of VAS and DASH scores.