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Abstract：
Background Periarthritis or frozen shoulder, also called adhesive capsulitis, is characterized by stiffness and pain along with gradual loss of active and passive movement in the glenohumeral joint. More than 2-5% of the population suffers from periarthritis with a higher incidence in the age group of 40-60 years. The various treatment modalities used for its management include simple physiotherapy, short-wave therapy, ultrasonic therapy, transcutaneous electrical nerve stimulation, hydrotherapy, analgesics, intra-articular injections, manipulation under general anesthesia (MUA), and surgical management. The application of intra-articular steroid injection has been a common and efficacious option in rapidly diminishing shoulder pain and disability. Some recent studies reported a better outcome using platelet-rich plasma (PRP) injections in frozen shoulder cases. Hence, this randomized controlled trial was conducted to compare the efficacy of intra-articular injections of PRP and triamcinolone in patients of shoulder periarthritis in a population from the eastern region of India Methodology A total of 60 patients with periarthritis shoulder were allocated into two groups after randomization. Group A received 2 mL autologous PRP, and Group B received 2 mL of triamcinolone (40 mg/mL) intra-articular injection. Patients were followed up on the 4th week, 12th week, and 24th week. The assessment of pain and function using the visual analog scale (VAS) score and the Disabilities of Arm, Shoulder, and Hand (DASH) score, respectively, was done at each follow-up. The primary analyses of both primary and secondary outcomes were conducted in the intention-to-treat (ITT) population. SPSS version 24 (IBM Corp., Armonk, NY, USA) was used for data analysis. Results The mean VAS score in the PRP and triamcinolone groups was 14.33 ± 3.79 and 31.63 ± 7.62, respectively (p = 0.0001) after 24 weeks. The mean DASH score in the PRP and triamcinolone groups was 18.08 ± 8.08 and 31.76 ± 3.63, respectively (p = 0.0001), which shows significant improvement in both pain and disability scores in the PRP group after 24 weeks. Conclusions The triamcinolone group showed better short-term outcomes whereas PRP showed better long-term outcomes in reducing pain and disability scores in terms of VAS and DASH scores.
摘要：
背景：肩周炎或肩周炎，也叫粘连性囊炎,以僵硬和疼痛为特征，并逐渐失去了在盂肱关节中的主动和被动运动。超过2-5％的人口患有关节炎，在40-60岁的年龄组中发病率较高。用于其管理的各种治疗方式包括简单的物理治疗，短波治疗,超声治疗,经皮神经电刺激,水疗,镇痛药,关节内注射,全身麻醉（MUA）下的操作，和手术管理。关节内类固醇注射的应用已成为快速减轻肩痛和残疾的常见且有效的选择。最近的一些研究报告了在冻结肩病例中使用富血小板血浆（PRP）注射的更好结果。因此，这项随机对照试验的目的是比较PRP和曲安奈德关节腔内注射对印度东部地区人群肩周炎患者的疗效。方法将60例肩周炎患者随机分为两组.A组接受2mL自体PRP,B组接受2mL曲安奈德（40mg/mL）关节腔内注射。患者在第4周随访,第12周,第24周。使用视觉模拟量表（VAS）评分和手臂残疾评估疼痛和功能，肩膀,和手（DASH）得分，分别,在每次随访中都做了。主要和次要结果的主要分析在意向治疗（ITT）人群中进行。SPSS版本24(IBMCorp.,Armonk,NY,美国)用于数据分析。结果24周后PRP组和曲安奈德组的平均VAS评分分别为14.33±3.79和31.63±7.62(p=0.0001)。PRP组和曲安奈德组的平均DASH评分分别为18.08±8.08和31.76±3.63(p=0.0001),显示24周后PRP组的疼痛和残疾评分均有显著改善.结论曲安奈德组显示出更好的短期结果，而PRP在降低疼痛和残疾评分方面显示出更好的长期结果。
