scholarly journals Effects of platelet-rich plasma injection on pain, range of motion, and disability in adhesive capsulitis: A prospective, randomized-controlled study

2021 ◽  
Vol 67 (4) ◽  
pp. 462-472
Author(s):  
Çağlar Karabaş ◽  
Havva Talay Çalış ◽  
Ulaş Serkan Topaloğlu ◽  
Çiğdem Karakükçü
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Platelet Rich Plasma ◽  
Adhesive Capsulitis ◽  
Controlled Study ◽  
Control Group ◽  
Plasma Injection ◽  
Active Flexion ◽  
Home Based ◽  
Significant Difference

Objectives: In this study, we aimed to investigate the effectiveness of intra-articular platelet-rich plasma (PRP) injection in adhesive capsulitis. Patients and methods: Between January 2019 and December 2019, a total of 40 patients (21 males, 19 females; mean age: 57.1±6.5 years; range, 44 to 72 years) with idiopathic adhesive capsulitis were included. The patients were randomly assigned into two equal groups as the PRP and the control group. The PRP group received two doses of PRP via intra-articular route biweekly under ultrasound guidance. No injection was performed to the control group. In both groups, stretching and Codman exercises were applied as a home- based program. The Visual Analog Scale (VAS), range of motion (ROM), and Shoulder Pain and Disability Index (SPADI) scores were evaluated before the treatment and at 2, 6 and 12 weeks after the treatment. Results: There were significant differences in all VAS, SPADI, and ROM scores at all time points after treatment compared to baseline in both groups. At the end of the study, there were significant differences in the active flexion, passive flexion, active abduction, passive abduction, and active external rotation scores at 12 weeks between the groups (p=0.012, p=0.015, p=0.008, p=0.019, and p=0.040, respectively). No significant difference was observed between the groups in terms of VAS and SPADI scores and the other parameters (active and passive extension, active and passive internal rotation, passive external rotation) at 2, 6, and 12 weeks (p>0.05). Conclusion: The addition of PRP to exercise treatment can improve patients' joint mobility, but not pain and disability in patients with adhesive capsulitis.

scholarly journals Short-Term Outcomes of Percutaneous Trephination with a Platelet Rich Plasma Intrameniscal Injection for the Repair of Degenerative Meniscal Lesions. A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study

2019 ◽  
Vol 20 (4) ◽  
pp. 856 ◽  
Author(s):  
Rafal Kaminski ◽  
Marta Maksymowicz-Wleklik ◽  
Krzysztof Kulinski ◽  
Katarzyna Kozar-Kaminska ◽  
Agnieszka Dabrowska-Thing ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Meniscal Tear ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Non Union ◽  
Parallel Group ◽  
Significant Difference ◽  
Clinically Significant ◽  
Patient Related Outcome

Meniscal tears are the most common orthopaedic injuries, with chronic lesions comprising up to 56% of cases. In these situations, no benefit with surgical treatment is observed. Thus, the purpose of this study was to investigate the effectiveness and safety of percutaneous intrameniscal platelet rich plasma (PRP) application to complement repair of a chronic meniscal lesion. This single centre, prospective, randomized, double-blind, placebo-controlled study included 72 patients. All subjects underwent meniscal trephination with or without concomitant PRP injection. Meniscal non-union observed in magnetic resonance arthrography or arthroscopy were considered as failures. Patient related outcome measures (PROMs) were assessed. The failure rate was significantly higher in the control group than in the PRP augmented group (70% vs. 48%, P = 0.04). Kaplan-Meyer analysis for arthroscopy-free survival showed significant reduction in the number of performed arthroscopies in the PRP augmented group. A notably higher percentage of patients treated with PRP achieved minimal clinically significant difference in visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) symptom scores. Our trial indicates that percutaneous meniscal trephination augmented with PRP results in a significant improvement in the rate of chronic meniscal tear healing and this procedure decreases the necessity for arthroscopy in the future (8% vs. 28%, P = 0.032).

scholarly journals COMPARISON OF INTRA-ARTICULAR METHYLPREDNISOLONE AND KETOROLAC INJECTIONS IN IMPROVING RANGE OF MOTION FOR DIFFERENT SHOULDER JOINT DISORDERS

2021 ◽  
Vol 71 (3) ◽  
pp. 819-22
Author(s):  
Sumeera Matee ◽  
Wasif Anwar ◽  
Sami Wahid ◽  
Saeed Bin Ayaz ◽  
Rana Shahid ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Joint ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Military Hospital ◽  
Prednisolone Acetate ◽  
Methyl Prednisolone ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Flexion Extension

Objective: To compare the efficacy of intra-articular injection of methyl prednisolone with ketorolac for improvement in range of motion in various shoulder joint disorders. Study Design: Quasi-experimental study. Place and Duration of Study: Departments of Internal and Rehabilitation Medicine, Combined Military Hospital Mangla, from Nov 2018 to May 2019. Methodology: Through non-probability consecutive sampling, patients with shoulder disorders were enrolled in the study and divided into two groups. Group A received intra articular corticosteroid injection and group B received intra-articular Ketorolac injection. Outcome was measured in terms of improvement in shoulder range of motion. Results: A total of 60 patients were selected, 40 (66.7%) male and 20 (33.3%) female. 30 (50%) patients had adhesive capsulitis, 24 (40%) had rotator cuff syndrome and 6 (10%) had impingement syndrome. 24 patients received methyl prednisolone acetate injection while 36 received ketorolac injection. There was no significant difference in the mean gain in flexion, extension, abduction, internal or external rotation between both groups (p=0.224, p=0.261, p=0.884, p=0.238, and p=0.584 respectively). Conclusion: There was no significant difference in efficacy of corticosteroid and ketorolac when injected intra-articularly in shoulder joint disorders.

scholarly journals Comparison of ultrasound-guided platelet-rich plasma injection and conventional physical therapy for management of adhesive capsulitis: a randomized trial

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097603
Author(s):  
Aung Chan Thu ◽  
Sang Gyu Kwak ◽  
Win Nyi Shein ◽  
La Min Htun ◽  
Thae Thae Han Htwe ◽  
...  
Keyword(s):  
Exercise Therapy ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Short Wave ◽  
Plasma Injection ◽  
Oral Pain ◽  
Evaluation Time ◽  
Significant Difference ◽  
Conventional Physiotherapy

Objective We evaluated the effect of ultrasound (US)-guided injection of platelet-rich plasma (PRP) into the shoulder joint in patients with adhesive capsulitis (AC) and compared its effect with that of conventional physiotherapy (CPT). Methods Sixty-four subjects with AC were included and randomly allocated into two groups, as follows: PRP (n=32; intra-articular [IA] PRP [4 mL] was injected); and CPT (n=32; short wave diathermy and exercise therapy were performed at three sessions/week for 6 weeks). Treatment outcomes evaluated therapeutic effectiveness before and at 1, 3, and 6 weeks after PRP injection and CPT initiation. Results Subjects in both groups showed a significant decrease in the visual analogue scale score for pain and shoulder and hand scores, and they a significant increase in shoulder passive range of motion at all evaluation time points. There was no significant difference in the measured outcomes between the two groups. However, there was less acetaminophen consumption after IA PRP injection compared with that after CPT. Conclusions IA PRP injection is a useful option for treating patients with AC, particularly those who have low therapeutic compliance for exercise therapy or have contraindications for corticosteroid injection or oral pain reduction medication.

scholarly journals Arthroscopic treatment of refractory adhesive capsulitis of the shoulder

2014 ◽  
Vol 41 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Marcos Rassi Fernandes
Keyword(s):  
Conservative Treatment ◽  
Range Of Motion ◽  
External Rotation ◽  
Constant Score ◽  
Adhesive Capsulitis ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Left Shoulder ◽  
Significant Difference

OBJECTIVE: to evaluate the results of arthroscopic treatment of refractory adhesive capsulitis of the shoulder associated as for improved range of motion after a minimum follow up of six years. METHODS: from August 2002 to December 2004, ten patients with adhesive capsulitis of the shoulder resistant to conservative treatment underwent arthroscopic surgery. One interscalene catheter was placed for postoperative analgesia before the procedure. All were in Phase II, with a minimum follow up of two years. The mean age was 52.9 years (39-66), predominantly female (90%), six on the left shoulder. The time between onset of symptoms and surgical treatment ranged from six to 20 months. Four adhesive capsulitis were found to be primary (40%) and six secondary (60%). RESULTS: the preoperative mean of active anterior elevation was 92°, of external rotation was 10.5° of the L5 level internal rotation; the postoperative ones were 149°, 40° and T12 level, respectively. Therefore, the average gain was 57° for the anterior elevation, 29.5° for external rotation in six spinous processes. There was a significant difference in movements' gains between the pre and post-operative periods (p<0.001). By the Constant Score (range of motion), there was an increase of 13.8 (average pre) to 32 points (average post). CONCLUSION: the arthroscopic treatment proved effective in refractory adhesive capsulitis of the shoulder resistant to conservative treatment, improving the range of joint movements of patients evaluated after a minimum follow up of six years.

scholarly journals A COMPARATIVE STUDY OF EFFICACY OF INTRAARTICULAR STEROID VS. PLATELET RICH PLASMA INJECTION IN ADHESIVE CAPSULITIS.

2020 ◽  
pp. 15-17
Author(s):  
Subhasish Pati ◽  
Joyshree Panda ◽  
Rajesh Pramanik
Keyword(s):  
Range Of Motion ◽  
Platelet Rich Plasma ◽  
Adhesive Capsulitis ◽  
Methyl Prednisolone ◽  
Plasma Injection ◽  
Relieve Pain ◽  
Reduction Of Pain ◽  
Long Term Follow Up ◽  
Group B

Introduction: Adhesive capsulitis is one of the major causes of restriction of movement and pain in shoulder joint. Over the years the efficacy of steroid injections to relieve pain and improve range of motion was well established. Platelet Rich Plasma (PRP) has few more properties in management of same and hence the study aims to show PRP as an alternative to steroids. Aim: To look for improvement in VAS, Range of Motion and SPADI due to PRP and steroids and to compare their efficacies. Materials and method: Two groups of Patients with adhesive capsulitis of shoulder were randomly selected. Group A (n=20) was injected with PRP and Group B (n=20) with methyl Prednisolone in aseptic technique after verbal consent. Assessment was done before the block then after 1st week, 4th week and 3months after the block. Results: Statistically significant improvement was seen in both the groups with long term improvement better with PRP. Conclusion: Although steroid showed better results in immediate reduction of pain compared to PRP but in long term follow up PRP was superior.

scholarly journals Effect of Peat Intervention on Pain and Gait in Patients with Knee Osteoarthritis: A Prospective, Double-Blind, Randomized, Controlled Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Myeongkyu Kim ◽  
Kyu Hoon Lee ◽  
Seung Hoon Han ◽  
Sung Jae Lee ◽  
Choong-Gon Kim ◽  
...  
Keyword(s):  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Range Of Motion ◽  
Matrix Protein ◽  
Intervention Group ◽  
Gait Velocity ◽  
Controlled Study ◽  
Control Group ◽  
Significant Difference ◽  
Hot Pack

Background/Purpose. Peat is a plant material that is decayed in anaerobic and acidic conditions. Peat is known for its pain relief effect on degenerative and rheumatologic diseases for hundreds of years. This research aims to see effects of peat intervention on knee osteoarthritis patients’ pain, biomarkers, and parameters about gait. Methods. Knee osteoarthritis patients with Visual Analog Scale (VAS) of 3 or more and Kellgren–Lawrence osteoarthritis grades 1 to 3 were included. Patients with history of intraarticular injection treatment were excluded. Forty-one participants were randomly allocated to the peat intervention group (n = 22) or the hot-pack-only control group (n = 19). Peat and hot pack were applied to both knees of each group of patients. Each intervention session lasted 20 minutes, and eight sessions were completed over five days. VAS, serum cartilage oligomeric matrix protein (COMP), and gait parameters were evaluated before and after the whole interventions. Results. VAS in the peat group decreased from 6.000 to 3.409 after intervention (p<0.001) and also decreased in the control group from 5.737 to 4.421 (p<0.001). VAS score reduction between two periods was greater in the peat group than that in the control group (p<0.001). There was no significant difference in the serum COMP level in either intergroup or intragroup analysis. In gait analysis, the gait velocity of the peat group increased from 0.781 m/s to 0.873 m/s after intervention (p=0.002), while it decreased in the control group. The knee varus/valgus range of motion during gaits was reduced from 11.455° to 8.439° after intervention in the peat group (p=0.006). Conclusions. This study showed that peat can be considered as a therapeutic option for pain relief of knee osteoarthritis patients. The reduction in knee joint varus/valgus range of motion and the increase in gait velocity after peat intervention were also identified through this research, which is the first to analyze the effects of peat on gait.

Clinical Study of Qingpeng Ointment Treatment of Shoulder-Hand Syndrome After Cerebral Hemorrhage During the Rehabilitation Period

2020 ◽  
Vol 23 ◽  
Author(s):  
Ruihuan Pan ◽  
Shanshan Ling ◽  
Haodong Yang ◽  
Yan Huang ◽  
Lechang Zhan ◽  
...  
Keyword(s):  
Treatment Group ◽  
Cerebral Hemorrhage ◽  
Clinical Medicine ◽  
External Rotation ◽  
Statistical Significance ◽  
Hand Function ◽  
Tibetan Medicine ◽  
Controlled Study ◽  
Control Group ◽  
The Difference

Background: Shoulder-hand syndrome (SHS) refers to a syndrome causing sudden edema, shoulder pain and limited hand function. Qingpeng ointment, a kind of Tibetan medicine, can reduce swelling, relieve pain, tonify stagnation and clear the meridians, which is consistent with the pathological mechanism of SHS after stroke. Therefore, if clinical trials can be used to explore the effectiveness of Qingpeng ointment for treatment of poststroke SHS and promote its application in clinical medicine, this is of specific significance for the treatment of poststroke SHS. Objective: To investigate the clinical efficacy and safety of Qingpeng ointment in the treatment of poststroke SHS. To provide an objective basis for a better therapeutic treatment for poststroke SHS． Method: A prospective, randomized, controlled study was conducted. This study recruited 120 patients with poststroke SHS who met the inclusion criteria. They were randomized into the treatment group and the control group, with 60 patients allocated to each group. The treatment group received routine medical treatment and rehabilitative care after using the Qingpeng ointment, while the patients in the control group received only routine treatment without the ointment. All patients received clinical assessment with the Visual Analogue Scale (VAS), measurement of the range of motion (ROM) of the upper-limb joints, the Fugl-Meyer Assessment of Upper Extremity (FMA-U) and the Modified Barthel Index Score (MBI) before and after the whole treatment. Results: After 4 weeks of treatment, the VAS scores of both groups were decreased significantly (P＜0.05), and the difference between the two groups was statistically significant (P < 0.05). There is no statistical significance for the difference between the treatment group and control group in terms of the FMA-U and MBI scores and the forward bend, backward, outstretch, external rotation and pronation angles after treatment. The increases in the values of VAS, FMA-M and MBI in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). The increases in the values of the forward bend, outreach and external rotation angles in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The treatment group showed better results than the control group in terms of the relief of pain symptoms, the improvement of motor function and the improvement of the activities of daily living for patients with shoulder-hand syndrome after cerebral hemorrhage. Qingpeng ointment is effective and safe in treating poststroke SHS.

Allogenic Pure Platelet-Rich Plasma Therapy for Adhesive Capsulitis: A Bed-to-Bench Study With Propensity Score Matching Using a Corticosteroid Control Group

2021 ◽  
pp. 036354652110186
Author(s):  
Min Ji Lee ◽  
Kang Sup Yoon ◽  
Sohee Oh ◽  
Sue Shin ◽  
Chris Hyunchul Jo
Keyword(s):  
Muscle Strength ◽  
Propensity Score ◽  
Inflammatory Cytokines ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Adhesive Capsulitis ◽  
Shoulder Function ◽  
Control Group ◽  
Inflammatory Condition

Background: While platelet-rich plasma (PRP) has been widely studied for musculoskeletal disorders, few studies to date have reported its use for adhesive capsulitis (AC). Fully characterized and standardized allogenic PRP may provide clues to solve the underlying mechanism of PRP with respect to synovial inflammation and thus may clarify its clinical indications. Purpose: To clinically evaluate the safety and efficacy of a fully characterized pure PRP injection in patients with AC and to assess the effects of pure PRP on synoviocytes with or without inflammation in vitro. Study Design: Controlled laboratory study and cohort study; Level of evidence, 3. Methods: For the clinical analysis, a total of 15 patients with AC received an ultrasonography-guided intra-articular PRP injection and were observed for 6 months. Pain, range of motion (ROM), muscle strength, shoulder function, and overall satisfaction in the patients were evaluated using questionnaires at 1 week as well as at 1, 3, and 6 months after the PRP injection and results were compared with the results of a propensity score−matched control group that received a corticosteroid injection (40 mg triamcinolone acetonide). For the in vitro analysis, synoviocytes were cultured with or without interleukin-1β (IL-1β) and PRP. The gene expression of proinflammatory and anti-inflammatory cytokines as well as matrix enzymes and their inhibitors was evaluated. Results: At 6-month follow-up, pure PRP significantly decreased pain and improved ROM, muscle strength, and shoulder function to levels comparable with those after a corticosteroid injection. All pain values, strength measurements, and functional scores significantly improved up to 6 months in the PRP group, but these measures improved up to 3 months and then were decreased at 6 months in the corticosteroid group. ROM was significantly improved in the 2 groups at 6 months compared with baseline. Allogenic PRP did not cause adverse events. For the in vitro findings, PRP induced inflammation but significantly improved the IL 1β−induced synovial inflammatory condition by decreasing proinflammatory cytokines such as IL-1β, tumor necrosis factor−α, IL-6, cyclooxygenase-2, and microsomal prostaglandin E synthase−1 and decreased matrix enzymes (matrix metalloproteinase−1, −3, and −13 as well as a disintegrin and metalloproteinase with thrombospondin motifs−4 and −5) and further increasing anti-inflammatory cytokines such as vasoactive intestinal peptide. Conclusion: This study showed that PRP decreased pain and improved shoulder ROM and function to an extent comparable with that of a corticosteroid in patients with AC. Allogenic pure PRP acted in a pleiotropic manner and decreased proinflammatory cytokines only in the inflammatory condition. Clinical Relevance: Allogenic PRP could be a treatment option for the inflammatory stage of AC.

scholarly journals Effect of mobile guided cardiac rehabilitation on quality of life – the EU-CaRE randomised clinical trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Houben ◽  
J.A Snoek ◽  
E Prescott ◽  
N Mikkelsen ◽  
A.E Van Der Velde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Control Group ◽  
Funding Source ◽  
Multi Centre Study ◽  
Old Patients ◽  
Home Based ◽  
Significant Difference

Abstract Background and purpose Although participation in cardiac rehabilitation (CR) improves quality of life (QoL), participation in CR, especially among elderly, is limited. We conducted this study to assess whether mobile home-based CR (mCR) increases QoL in elderly (≥65 years old) patients with coronary artery disease (CAD) or a valvular intervention who decline participation in conventional CR. Methods It is designed as a randomised multi-centre study with two parallel arms. Randomisation assigned patients either to mCR or a control group. mCR Consisted of six months of home-based CR with telemonitoring and coaching. Control-group patients did not receive any form of CR throughout the study period. Quality of life was measured with the SF-36v2 questionnaire at 0, 6 and 12 months. Results A total of 179 patients were included in this study (90 control, 89 mCR). A flowchart of the trial is presented in Figure 1. Patients were predominantly male (81.1%). Baseline characteristics can be found in Table 1. Patients using mCR improved on physical QoL after 6 (p=0.026) and 12 (p=0.008) months. There was no difference on mental QoL for both groups (mCR 6 months p=0.563, 12 months p=0.945; control 6 months p=0.589, 12 months p=0.542). No difference existed in QoL between the mCR and control group (physical: 6 months p=0.070, 12 months p=0.150; mental: 6 months p=0.355, 12 months p=0.625). Conclusion Although there is no significant difference in QoL between the control and mCR group, mCR increases physical QoL after 6 and 12 months in elderly patients who decline participation in conventional CR. Therefore E-Health tools should be considered as an alternative for conventional CR when (elderly) patients decline to participate in conventional CR. Figure 1. Flow chart of all eligible patients Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme

scholarly journals An MRI-Based Patient-Specific Computational Framework for the Calculation of Range of Motion of Total Hip Replacements

2021 ◽  
Vol 11 (6) ◽  
pp. 2852
Author(s):  
Maeruan Kebbach ◽  
Christian Schulze ◽  
Christian Meyenburg ◽  
Daniel Kluess ◽  
Mevluet Sungu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Computer Aided Design ◽  
External Rotation ◽  
Patient Specific ◽  
Computational Framework ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Significant Difference ◽  
Hip Replacements

The calculation of range of motion (ROM) is a key factor during preoperative planning of total hip replacements (THR), to reduce the risk of impingement and dislocation of the artificial hip joint. To support the preoperative assessment of THR, a magnetic resonance imaging (MRI)-based computational framework was generated; this enabled the estimation of patient-specific ROM and type of impingement (bone-to-bone, implant-to-bone, and implant-to-implant) postoperatively, using a three-dimensional computer-aided design (CAD) to visualize typical clinical joint movements. Hence, patient-specific CAD models from 19 patients were generated from MRI scans and a conventional total hip system (Bicontact® hip stem and Plasmacup® SC acetabular cup with a ceramic-on-ceramic bearing) was implanted virtually. As a verification of the framework, the ROM was compared between preoperatively planned and the postoperatively reconstructed situations; this was derived based on postoperative radiographs (n = 6 patients) during different clinically relevant movements. The data analysis revealed there was no significant difference between preoperatively planned and postoperatively reconstructed ROM (∆ROM) of maximum flexion (∆ROM = 0°, p = 0.854) and internal rotation (∆ROM = 1.8°, p = 0.917). Contrarily, minor differences were observed for the ROM during maximum external rotation (∆ROM = 9°, p = 0.046). Impingement, of all three types, was in good agreement with the preoperatively planned and postoperatively reconstructed scenarios during all movements. The calculated ROM reached physiological levels during flexion and internal rotation movement; however, it exceeded physiological levels during external rotation. Patients, where implant-to-implant impingement was detected, reached higher ROMs than patients with bone-to-bone impingement. The proposed framework provides the capability to predict postoperative ROM of THRs.

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