Efficacy of Pure Platelet-Rich Plasma (P-PRP) in Adhesive Capsulitis of the Shoulder: A Prospective Clinical Study of 50 Cases

Vollständiger Abstract

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Background: Adhesive capsulitis ("frozen shoulder") is a chronic, painful disorder that limits function and is more prevalent in diabetics, with a reported prevalence of up to 30% in this subgroup. Conventional treatments include corticosteroids, hydrodilatation, arthroscopic release, and physiotherapy, but these often provide only temporary benefit or carry risks — particularly hyperglycemia with steroids. Pure platelet-rich plasma (P-PRP) is an autologous biologic preparation with minimal leukocytes, rich in growth factors, offering a regenerative mechanism for recovery without systemic side effects. Methods: A prospective single-center study was conducted on 50 patients (age 40–70 years) with idiopathic adhesive capsulitis unresponsive to ?4 weeks of conservative therapy. P-PRP was prepared by double centrifugation with minimal leukocyte content and injected intra-articularly into the glenohumeral joint. Outcomes were measured using the Visual Analogue Scale (VAS) for pain and range of motion (ROM) for abduction, external rotation, and forward flexion at baseline, 6, 12, and 24 weeks, and Constant–Murley Score (CMS) at 12 and 24 weeks. Results: Mean VAS improved from 8.2 at baseline to 1.8 at 24 weeks (p<0.001). Abduction improved from 60° to 150°, external rotation from 20° to 65°, and forward flexion from 90° to 165° at 24 weeks. CMS improved from 38.5 at baseline to 72.4 at 12 weeks and 82.7 at 24 weeks. Gains were statistically significant at all intervals and sustained at 24 weeks. No allergic reactions occurred. PRP was safe in diabetics, with no glycemic deterioration observed.