Platelet rich plasma versus hyaluronic acid injection in chronic painful shoulder: Randomized blind clinical trial

Abstract

Background: Shoulder pain is considered a disabling problem and is a frequent reason for consultation in general practice. The prevalence of shoulder pain has been reported to range from 7% to 36% of population. Platelet-rich plasma (PRP) releases cytokines, which are delivered of the injury to facilitate healing. Hyaluronic acid (HA) has a lubricant and anti-inflammatory effect. The aim of this study was to compare the effect of PRP versus HA in the treatment of chronic shoulder pain. Patients and Methods: This study was a prospective randomized trial on patients with chronic shoulder pain. Fifty patients were represented into two groups based on injected material: PRP group and HA group, assessment done before and after injections (4 weeks and 6 months) by using Visual Analog Scale (VAS), constant score (CS), and Shoulder Pain and Disability Index (SPADI). Results: The study results showed that at 4 weeks after injection, the PRP group had a significantly higher Constant score in comparison to the HA group (60.91 ± 3.89 vs. 57.38 ± 6.22, P = 0.02), but no difference was at baseline and after 6 months. Furthermore, both groups had insignificant differences as regards baseline SPADI (58.77 ± 2.89 vs. 60.64 ± 3.51; P = 0.06) and 6-month follow-up after injection SPADI (55.44 ± 4.71 vs. 57.12 ± 4.40; P = 0.19), but at 4 weeks after injection, the PRP group had significantly lower SPADI in comparison to the HA group (53.52 ± 3.22 vs. 55.36 ± 2.98; P = 0.04). Conclusion: Both PRP and HA groups showed statistically significant better outcomes in VAS, CS, and SPADI during follow-up visits, but PRP was found to be superior to HA at 4-week follow-up post injection.

Keywords

• chronic painful shoulder
• hyaluronic acid
• platelet-rich plasma
• ultrasound