Platelet-Rich Plasma Versus Corticosteroid Injection in Patients With Primary Frozen Shoulder: A Single-Blinded Randomized Controlled Trial.

Abstract

To compare the effects of combined glenohumeral joint (GHJ) and subacromial-subdeltoid (SASD) bursa injections using platelet-rich plasma (PRP), corticosteroids (CSs), or normal saline (NS), in conjunction with physical therapy (PT), for the treatment of frozen shoulder. Prospective, single-blinded, randomized controlled trial. Rehabilitation clinic in a medical center. Ninety patients with primary frozen shoulder. Participants were randomly assigned to one of the 3 intervention groups: PRP injection + PT (n = 30), CS injection + PT (n = 30), and NS injection + PT (n = 30). Each participant received 2 ultrasound-guided injections targeting both the GHJ and SASD bursa. The primary outcome was the Shoulder Pain and Disability Index (SPADI). Secondary outcomes included the Shoulder Disability Questionnaire (SDQ), pain visual analog scale (VAS), active and passive range of motion, the 36-Item Short Form Health Survey (SF-36), and patient self-assessment. Assessments were performed at baseline and at 1, 2, 4, and 6 months following treatment initiation. The CS group exhibited significantly greater improvement in SPADI (P < .001), SDQ (P < .001), pain VAS during activity (P = .005), active abduction (P = .022), active internal rotation (P = .036), passive abduction (P = .012), passive internal rotation (P = .029), self-assessment (P < .001), and selective SF-36 domains. The therapeutic effect of CS was evident at 1 month and persisted through the 6-month follow-up. Corticosteroid injections yielded superior outcomes compared with PRP, particularly during the freezing stage of frozen shoulder. Nonetheless, all 3 treatment groups exhibited significant postintervention improvement.