Platelet-rich plasma as a potential prophylactic measure against frozen shoulder in an in vivo shoulder contracture mode
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ORTHOPAEDIC SURGERY
Platelet‑rich plasma as a potential prophylactic measure against frozen shoulder in an in vivo shoulder contracture model Oscar Feusi1 · Agnieszka Karol2 · Thea Fleischmann3 · Brigitte von Rechenberg2 · Samy Bouaicha1,4 · Clément M. L. Werner1 · Thorsten Jentzsch1,4 Received: 22 August 2019 / Accepted: 30 September 2020 © The Author(s) 2020
Abstract Introduction Frozen shoulder (adhesive capsulitis) is a common painful and functionally-limiting disease affecting around 2% of the population. So far, therapeutic options are limited and often unsatisfactory. Platelet-rich plasma (PRP) has been used as a treatment option in other orthopedic diseases since it contains growth factors that stimulate tissue repair. So far, the effect of PRP on frozen shoulder lacks evidence. We hypothesized that PRP may be valuable in the prophylaxis and treatment of secondary frozen shoulder due to capsular remodeling. Materials and methods An experimental study of an in vivo frozen shoulder model was conducted. Twenty Sprague–Dawley rats underwent surgery in which the body of the scapula was connected to the humerus with a high-strength suture. Two groups of 8 weeks survival time were allocated; a treatment group with one intraoperative injection of PRP into the glenohumeral joint (n = 10) and a control group without PRP (n = 10). The primary outcome was the structural change in the posterior synovial membrane of the posterior and inferior part of the glenohumeral joint using a semi-quantitative grading from 0 (lowest) to 3 (highest). Results The posterior synovial membrane structural changes were significantly lower in the PRP group (median = 1 [interquartile range (IQR) = 0–1]) compared to controls (median = 2 [IQR = 1–3]) (p = 0.028). There were no differences for the remaining synovial membrane changes and fibrous capsule responses between groups. Conclusions In this in vivo shoulder contracture model, PRP injections seem to reduce the histological severity grade of some parts (i.e., posterior synovial membrane changes) of the secondary frozen shoulder without causing any side effects. It may be considered to investigate this effect further in future studies as a potential prophylaxis of secondary frozen shoulder (e.g., in operated or immobilized shoulders) or as a treatment option for patients with frozen shoulder in the early stage. Keywords Frozen shoulder · Adhesive capsulitis · Platelet-rich plasma · Shoulder · Injection · Infiltration
Clément M. L. Werner, Thorsten Jentzsch contributed equally to this study. * Oscar Feusi [email protected]
Thorsten Jentzsch [email protected]
Agnieszka Karol [email protected]
1
Thea Fleischmann [email protected]
Department of Trauma, University Hospital Zurich, University of Zurich, Zurich, Switzerland
2
Musculoskeletal Research Unit (MSRU) Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland
3
Division of Surgical Research, Centre for Clinical Research, Universi
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