Abstract
Context
Osteoarthritis (OA) is a degenerative joint disorder that causes joint pain and stiffness. Platelet-rich plasma (PRP) is considered a recent effective line of management of OA.
Aims
To compare the effect of local injection of PRP versus steroid in shoulder OA and their relation to quality of life.
Patients and methods
This study included 50 patients with mild–moderate OA shoulder diagnosed according to Samilson and Prieto grading system of shoulder OA and were recruited from the outpatient clinic of physical medicine, and rehabilitation, Faculty of Medicine, Menoufia University Hospital, in the period between 2017 and 2018. The study included both sexes. Group I included 25 patients who were injected intra-articularly with PRP in the affected shoulder, and group II included 25 patients who were injected with triamcinolone acetate. They were evaluated by Western Ontario Osteoarthritis Shoulder index and visual analogue scale before and after injection.
Statistical analysis
A descriptive and analytic study by SPSS, version 16, on IBM compatible computer was done.
Results
There was a highly statistical significant difference between preinjection and postinjection parameters regarding Western Ontario Osteoarthritis Shoulder score and visual analogue scale in both groups, with more improvement in the PRP group.
Conclusion
Intra-articular injections with PRP and steroids are effective less-invasive lines of shoulder OA treatment, with superiority to PRP owing to more persistence of its effects.
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References
Sanchez-Adams J, Leddy HA, McNulty AL, O’Conor CJ, Guilak F. The mechanobiology of articular cartilage: bearing the burden of osteoarthritis. CurrRheumatol Rep 2014; 16:451
Sinusas K. Osteoarthritis: diagnosis and treatment. Am Fam Physician 2012; 85:49–56
Millett PJ, Gobezie R, Boykin RE. Shoulder osteoarthritis: diagnosis and management. Am Fam Physician 2008; 78:605–611
Chillemi C, Franceschini V. Sholder osteoarthritis. Arthritis J 2013; 2013:370231
Heidari B. Knee osteoarthritis diagnosis, treatment and associated factors of progression: part II. Caspian J Intern Med 2011; 2:249–255
Smyth NA, Murawski CD, Fortier LA, Cole BJ, Kennedy JG. Platelet-rich plasma in the pathologic processes of cartilage: review of basic science evidence. Arthroscopy 2013; 29:1399–1409
Drengk A, Zapf A, Stürmer EK, Stürmer KM, Frosch KH. Influence of platelet-rich plasma on chondrogenic differentiation and proliferation of chondrocytes and mesenchymal stem cells. Cells Tissues Organs 2009; 189:317-326
van Buul GM, Koevoet WL, Kops N, Bos PK, VerhaarJA, Weinans H, et al. Platelet-rich plasma releasate- sate inhibits inflammatory processes in osteoarthritic chondrocytes. Am J Sports Med 2011; 39:2362–2370
Anitua E, Sánchez M, Nurden AT, Zalduendo MM, de la Fuente M, Azofra J, et al. Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford) 2007; 46:1769–1772
Descalzi F, Ulivi V, Cancedda R, Piscitelli F, Luongo L, Guida F, et al. Platelet-rich plasma exerts anti-nociceptive activity by a peripheral endocannabinoid-related mechanism. Tissue Eng Part A 2013; 19:2120–2129
Brox Jl, Lereim P, Merckoll E, Finnanger AM. Radiographic classification of glenohumeral arthrosis. Acta Orthop Scand 2003; 74:186–189
Griffin S, Lo IKY, Kirkley A. The development of a disease-specific quality of life measurement tool for osteoarthritis: The Western Ontario Osteoarthritis of the Shoulder (WOOS) Index. Osteoarthr Cartil 2001; 9:771–778
Gould D, Kelly D, Goldstone L, Gammon J. Visual Analogue Scale (VAS). J ClinNurs 2001; 10:697–706
Dauphin PA, Guillemin F, Virion JM, Briançon S. Bias and precision in visual analogue scales: a randomized controlled trial. Am J Epidemiol 1999; 150:1117–1127
Mazzucco L, Balbo V, Cattana E, Guaschino R, Borzini P. Not every PRP-gel is born equal: evaluation of growth factor availability for tissues through four PRP-gel preparations. FibrinetR, RegenPRP-KitR, PlateltexR and one manual procedure. Vox Sang 2009; 97:110–118
Napolitano M, Matera S, Bossio M, Crescibene A, Costabile E, Almolla J, et al. Autologous platelet gel for tissue regeneration in degenerative disorders of the knee. Blood Tranfus 2012; 10:72–77
Levesque R. SPSS programming and data management. A guide for SPSS and SAS Users. 4th ed. Chicago, IL: SPSS Inc; 2007
Thomas M, Bidwai A, Rangan A, Rees JL, Brownson P.et al... Patient care pathways glenohumeral osteoarthritis. Shoulder Elbow 2016; 8:203–214
Freitag J. The effect of photoactivated platelet-rich plasma injections in the novel treatment of shoulder osteoarthritisDisord. Int J Case Rep Images 2017; 5:546–552
Hirahara AM. Platelet-rich plasma vs. cortisone injections for the nonsurgical treatment of shoulder pain. San Diego, CA: Arthroscopy Association of North America (AANA), Annual Meeting; 2011
Connolly B. Platelet rich plasma (PRP) versus cortisone. 2017. Available at: http://www.drbenconnolly.ca/platelet-rich-plasma-prp-versus-cortisone. [Accessed on 2017 Mar 12]
Merolla G, Sperling JW, Paladini P, Porcellini G. Efficacy of Hylan. G-F 20 versus 6-methylprednisolone acetate in painful shoulder osteoarthritis: a retrospective controlled trial. Musculoskelet Surg 2011; 95:215–224
Ucuncu F, Capkin E, Karkucak M, Ozden G, Cakirbay H, Tosun M, et al. Comparison of the effectiveness of landmark-guided injections and ultrasonography guided injections for shoulder pain. In Clin J Pain 2009; 25:786–789
Kothari SY, Srikumar V, Singh N. Comparative efficacy of platelet rich plasma injection, corticosteroid injection and ultrasonic therapy in the treatment of periarthritis shoulder. J Clin Diagn Res 2017; 11:15–18
Rastogi K, Davis KW, Ross A, Rosas HG. Fundamentals of joint injection. Am J Roentgenol 2016; 207:484–494
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Saif, D.S., Serag, D.M. & El Tabl, M.A. Comparative study between platelet-rich plasma injection and steroid injection in mild–moderate shoulder osteoarthritis and their relation to quality of life. Egypt Rheumatol Rehabil 46, 55–61 (2019). https://doi.org/10.4103/err.err_17_18
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DOI: https://doi.org/10.4103/err.err_17_18