Randomized control trial comparing results of platelet rich plasma with steroid injection in subacromial impingement syndrome

Vol 35 | Issue 1 | Jan-April 2020 | page: 21-25 | Pulkesh Singh, Santosh Kumar Singh, Simrat Pal Singh Gill

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Authors: Pulkesh Singh [1]], Santosh Kumar Singh [2], Simrat Pal Singh Gill [2]

¹K. D. Medical College, Hospital & Research Center, Mathura, U.P, India.

2 Uttar Pradesh University of Medical Sciences Saifai, Etawah, U.P, India

 

Address of Correspondence:
Dr. Pulkesh Singh,
K. D. Medical College, Hospital & Research Center, Mathura, U.P, India.
E-mail: doctorpulkesh@gmail.com


Background: One of the most common causes of shoulder pain in adults is Subacromial impingement syndrome. Use of Platelet rich plasma is among the current emerging concepts in the treatment of this syndrome. This study aimed to compare the effects of subacromial injection of Platelet rich plasma (PRP) with Steroid injection in treatment of shoulder impingement syndrome. The clinical condition and functional outcome scores before and after the treatment were evaluated.
Methods: The study was conducted in the department of orthopedics of a tertiary level centre. Cases were selected from the patients attending routine OPD of orthopaedics department from January 2015 to December 2017 that had not responded to conservative treatment with NSAID and exercises for 4 weeks. A total of 100 patients were selected for the study. These were divided into two equal groups of 50 patients each. Group A (n=50) patients were treated with Single dose injection of mixture of 1 ml of steroid (Depo-Medrol containing 40mg/ml of Methylprednisolone) and 5 ml of Xylocaine. Group B (n=50) patients were treated with Single dose injection of 3 ml of autologous platelet rich plasma. The patients were followed up at 2 weeks, 6 weeks and 6 months after treatment and evaluated clinically and functionally using visual analogue scale (VAS) score for pain and the Constant–Murley score.
Results: There was an improvement in mean VAS scores and mean Constant-Murley scores in both the groups. The mean VAS score improved from 7.2 to 5.4 at 2 weeks, 2.8 at 6 weeks and 1.7 at 6 months in Group A. The mean VAS score improvement in Group B was 6.8 at 2 weeks, 5.7 at 6 weeks and 4.5 at 6 months compared to initial VAS score of 7.4 in this group. In Group A the mean Constant score increased from 37.5 at baseline to 51.6 at 2 weeks, 55.3 at 6 weeks and 63.7 at the end of 6 months after the injection; whereas it increased from 39.8 at baseline to 40.7 at 2 weeks, 42.1 at 6 weeks and 51.4 at 6 months of receiving the injection in Group B. Both the groups showed clinical improvement but the improvement in the mean Constant score and mean VAS score at 2 weeks, 6 weeks and 6 months was significantly better in Group A (Steroid) than Group B (PRP). This difference in improvement in both the groups was statistically significant (p Value ˂0.05).
Conclusion: In our study the results for steroid injection were better than injection of platelet rich plasma for treatment of subacromial impingement syndrome. The clinical improvements as well as improvement in VAS scores and Constant scores were significantly greater with steroid injection than with PRP injection.
Keywords: Platelet rich plasma (PRP), Steroid, Subacromial impingement syndrome, Constant-Murley Score, Visual analogue scale (VAS).


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How to Cite this Article: Singh P, Singh S K, Singh Gill S P | Randomized control trial comparing results of platelet rich plasma with steroid injection in subacromial impingement syndrome | Journal of Bone and Joint Diseases | Jan-April 2020;35(1): 21-25.

 



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