Effect of Platelet Rich Plasma Therapy for Shoulder Osteoarthritis: Double Blinded Randomized Controlled Study

Abstract

Platelet-rich plasma (PRP) is widely used in musculoskeletal conditions and orthopaedic surgery ranging from clinic-based injections for tendinopathies to intra-operative application to augment soft-tissue healing. It has been used in knee osteoarthritis, rotator cuff tears, elbow epicondylitis, anterior cruciate ligament reconstruction, shoulder impingement syndrome and various tendinopathies to date, with an expanding list of indications. While available evidence supports the use of PRP in the management of lateral epicondylitis and knee osteoarthritis, there is limited clinically significant evidence for other indications PRP is generated from centrifugation of whole blood to yield a higher than usual concentration of platelets in a small volume of plasma. Platelets contain a range of growth factors and cytokines such as transforming growth factor-β, insulin-like growth factor, platelet-derived growth factor and vascular endothelial growth factor. These are involved in the regulation of chemotaxis, angiogenesis, cell proliferation and differentiation. They have been shown to enhance healing by stimulating angiogenesis and production of collagen. Thus, PRP potentially improves clinical outcomes by improving inflammatory symptoms as well augmenting labral and cartilage healing. However, the use of PRP is still an evolving field and there is a need for more high-quality literature on its efficacy in clinical practice. This study aims to evaluate the efficacy of platelet-rich plasma as a treatment for primary and secondary shoulder osteoarthritis pain.