Efficacy of Ultrasound-Guided Glenohumeral Joint Injections of Leukocyte-Poor Platelet-Rich Plasma Versus Hyaluronic Acid in the Treatment of Glenohumeral Osteoarthritis: A Randomized, Double-Blind Controlled Trial

Jonathan S. Kirschner, Jennifer Cheng, Andrew Creighton, Kristen Santiago, Nicole Hurwitz, Mark Dundas, Nicholas Beatty, Dallas Kingsbury, Gabrielle Konin, Zafir Abutalib, Richard Chang

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective:To compare the efficacy of ultrasound-guided hyaluronic acid (HA) versus leukocyte-poor platelet-rich plasma (LP-PRP) injection in the treatment of glenohumeral osteoarthritis.Design:Double-blind randomized controlled trial.Setting:Academic institution.Patients:Seventy patients with chronic glenohumeral osteoarthritis were randomly assigned to receive a single injection of HA (n = 36) or LP-PRP (n = 34).Interventions:Leukocyte-poor platelet-rich plasma was processed using Harvest/TerumoBCT Clear PRP kits. Ultrasound-guided injections of 6 mL HA or 6 mL LP-PRP into the glenohumeral joint were performed. Patients, the injecting physician, and outcomes assessor were blinded to treatment assignments.Main outcome measures:Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) score, current/average numerical rating scale (NRS) pain scores, satisfaction, and side effects were assessed at the 5 follow-up time points over 12 months.Results:Baseline characteristics were similar between groups. There were no significant between-group differences regarding SPADI, ASES, and current/average NRS pain scores at any time point up to 12 months postinjection (P > 0.05). However, significant improvements in SPADI, ASES, and current/average NRS pain scores were observed in both groups starting at 1 or 2 months (P < 0.01, P < 0.01, P < 0.001, and P < 0.01, respectively). These improvements were observed regardless of osteoarthritis severity. For patients who received LP-PRP, there was no effect of platelet yield on outcomes. Side effect and satisfaction rates were similar between groups.Conclusions:There were no differences in pain and functional outcomes after a single injection of LP-PRP versus HA. However, significant improvements in pain and function were observed after both treatments in patients with glenohumeral osteoarthritis.

Original languageEnglish
Pages (from-to)558-566
Number of pages9
JournalClinical Journal of Sport Medicine
Volume32
Issue number6
DOIs
StatePublished - 1 Nov 2022

Keywords

  • glenohumeral osteoarthritis
  • hyaluronic acid
  • pain
  • platelet-rich plasma
  • shoulder

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