Frozen shoulder is a very common condition that causes pain and stiffness in the shoulder. The exact cause is unknown. The condition can develop without an obvious cause or can be triggered by a seemingly minor injury. The traditional treatment options include injections with corticosteroids, hydrodilatation or surgical releases. Only very few scientific publications investigate the use of PRP in frozen shoulder. These studies demonstrate good outcomes, but only have a very short follow-up time of 12 weeks. At the Orthobiologics Clinic we feel that PRP could be a good treatment option for patients who are concerned over the use of corticosteroids and diabetic patients whose blood sugar control is often badly affected by steroid injections. We are hopeful that further research will strengthen the case for using PRP in the treatment of frozen shoulder.
The authors randomly allocated 195 patients with frozen shoulder to treatment with either a single PRP injection, a single corticosteroid injection or ultrasound treatment. All patients were given a home exercise regime. After 12 weeks patients in the PRP group had seen greater improvements in pain, stiffness and function than patients in the corticosteroid or ultrasound groups.
At the Orthobiologics Clinic we were interested to see PRP used for the treatment of frozen shoulders. We liked the study design with randomisation and a large cohort of patients. We would have preferred to see a longer follow-up time than just 12 weeks. The results however are positive enough to justify the use of PRP in patients in whom the use of corticosteroids is contraindicated and patients who have other concerns over the use of corticosteroid injections. We would welcome a randomised trial where PRP is tested against Hydrodilatation.
This trial compares the outcomes of patients with frozen shoulder who were either treated with a single corticosteroid injection or a single PRP injection. There were 30 patients in each group and patients were followed up for 12 weeks. After 12 weeks patients in the PRP group showed better outcomes in terms of pain, disability and range of movement.
At the Orthobiologics clinic we would have preferred to a randomised trial rather than a comparison of two non-randomised groups of patients. We would have also preferred a longer follow-up time. Within those limitation however we were encouraged to see another publication supporting the use of PRP instead of corticosteroids.