Disclosures: Jonathan S. Kirschner, MD: Foundation for PMR (Products/Services: Yes) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)HSS (Products/Services: No) (Employment)Select Medical Corp (Products/Services: No) (Honorarium)United States Bone and Joint Initiative (Products/Services: No) (Officer or Board Member)

Objective: To assess the efficacy of leukocyte-poor platelet-rich plasma (LP-PRP) versus hyaluronic acid (HA) as treatments for chronic glenohumeral osteoarthritis.

Design: Randomized controlled trial Setting : Academic medical center Participants : 70 patients who were randomly assigned to LP-PRP (n=34) or HA (n=36) groups.

Interventions: Patients in both groups underwent venipuncture, with blood draw for the LP-PRP group only. LP-PRP was processed from 60 mL whole blood using the Harvest/TerumoBCT kit. Either 6 mL LP-PRP or 6 mL low-molecular weight HA was injected into the affected glenohumeral joint of patients randomized into the LP-PRP or HA group, respectively. Needle guidance and injections were performed under ultrasound guidance. Patients avoided non-steroidal anti-inflammatory drugs for 8 weeks post-procedure.

Main Outcome Measures: Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) score, numerical rating scale (NRS) pain scores (current, average), sleep quality, general well-being, satisfaction, and side effects were longitudinally assessed at 4 follow-up time points over 1 year. Intention-to-treat analyses were performed using linear mixed models with repeated measures and generalized estimating equations.

Results: Baseline characteristics were similar between groups. In both groups, significant improvements in SPADI, ASES, current pain, and average pain scores were observed starting at 1 or 2 months, up to 12 months post-procedure (p < 0.01, p < 0.01, p < 0.001, and p < 0.01, respectively). Sleep quality and general well-being were unchanged. There were no between-group differences in outcomes. The overall side effect rate was 3.3%; weakness was the most common. Furthermore, the overall satisfaction rate was 71% and was similar between groups. Conclusions: SPADI and NRS pain scores significantly improved within LP-PRP and HA groups over time. No between-group differences in patient-reported outcomes were observed, and side effects were minimal. These findings suggest that injections of either LP-PRP or HA are effective in reducing pain and improving function in patients with glenohumeral osteoarthritis.

Level of Evidence: Level I

« Back to AAPM&R Annual Assembly 2020

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/efficacy-of-ultrasound-guided-glenohumeral-joint-injections-of-platelet-rich-plasma-versus-hyaluronic-acid-in-the-treatment-of-glenohumeral-osteoarthritis-a-randomized-double-blind-controlled-trial/