To compare the efficacy in terms of functional outcome of platelet-rich plasma injection and corticosteroid injection in periarthritis shoulder non-responsive to conventional ultrasonic therapy

Background: Periarthritis of the shoulder (adhesive capsulitis/frozen shoulder) is a painful condition with progressive restriction of movement. Conventional conservative therapies, including ultrasonic therapy, often yield suboptimal results. Corticosteroid injections provide short-term relief but carry concerns over diminishing long-term efficacy and potential side effects. Platelet-rich plasma (PRP), a regenerative therapy, has gained attention for promoting sustained recovery in chronic musculoskeletal disorders. This study compares the clinical and functional outcomes of PRP versus corticosteroid injections in periarthritis shoulder unresponsive to ultrasonic therapy. Aims and Objectives: To assess and compare functional outcomes of PRP and corticosteroid injections in refractory periarthritis shoulder. Materials and Methods: Participants first underwent ultrasonic therapy (7 min, 1.5 W/cm2, 1 MHz, continuous mode) every 3rd day for 14 days, plus a 10-min home exercise regimen twice daily. Non-responders were randomized: Group A received intra-articular PRP (2 mL) with lignocaine, Group B received triamcinolone (2 mL, 40 mg/mL) with lignocaine. Post-injection care included 48-h movement restriction, cold compresses, and paracetamol as needed, followed by resumption of exercises. Outcomes (Visual Analog Scale [VAS], quick disabilities of the arm, shoulder, and hand [QuickDASH], shoulder pain and disability index [SPADI], and range of motion for multiple planes) were assessed at baseline, 3, 6, 12, and 24 weeks. Results: Baseline characteristics were comparable. At 24 weeks, PRP yielded the greatest improvements: abduction (115.09° vs. corticosteroid 95.36°), flexion (101.88° vs. 87.52°), and sustained gains in internal rotation and extension. VAS scores declined markedly in the PRP group (7.58→2.67), with less pain relief in the corticosteroid (7.48→6.27) and ultrasonic groups (7.67→6.47). Functional indices (QuickDASH, SPADI) mirrored these trends. Conclusion: PRP injections offered superior, longer-lasting pain relief and functional improvement compared to corticosteroids in refractory periarthritis shoulder, supporting its inclusion in management protocols for chronic cases.