Efficacy of Platelet-Rich Plasma Injection on Range of Motion, Pain, and Disability in Patients With Adhesive Capsulitis: A Systematic Review and Meta-analysis

To investigate the therapeutic effects of platelet-rich plasma (PRP) injection on range of motion, pain, and disability in patients with adhesive capsulitis (AC). The authors performed the literature search in the PubMed, Embase, and Cochrane Library databases in February 2023. Prospective studies comparing the outcomes of PRP with other intervention in patients with AC. The quality of included randomized trials was assessed using the revised Cochrane Risk of Bias (RoB 2.0) tool. The Risk of Bias in Non-Randomized Studies of Interventions tool was applied to assess the quality of nonrandomized trials. The mean difference (MD) or standardized mean difference (SMD) was determined as the effect size for continuous outcomes, and outcome accuracy was determined using 95% confidence intervals (CIs). Fourteen studies involving 1139 patients were included. Our meta-analysis revealed that PRP injection can significantly improve passive abduction (MD=3.91; 95% CI, 0.84-6.98), passive flexion (MD=3.90; 95% CI, 0.15-7.84), and disability (SMD=−0.50; 95% CI, −1.29 to −0.74) within 1 month after intervention. Moreover, PRP injection can significantly improve passive abduction (MD=17.19; 95% CI, 12.38-22.01), passive flexion (MD=17.74; 95% CI, 9.89-25.59), passive external rotation (MD=12.95; 95% CI, 10.04-15.87), pain (MD=−8.40; 95% CI, −16.73 to −0.06), and disability (SMD=−1.02; 95% CI, −1.29 to −0.74) 3 months after intervention. PRP injection can also significantly improve pain (MD=−18.98; 95% CI, −24.71 to −13.26), and disability (SMD=−2.01; 95% CI, −3.02 to −1.00) 6 months after intervention. In addition, no adverse effects of PRP injection were reported. PRP injection may serve as an effective and safe treatment for patients with AC.