Effect of PRP as Therapy for Shoulder Osteoarthritis

Study Overview
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Brief Summary
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Patients with shoulder osteoarthritis are suffering from pain and disabilities which lead to difficulties in life. The presence of platelet-rich plasma as regenerative therapy which helps in healing of damaged tissues like ligaments and joint might be of great benefit in managing such conditions.

Detailed Description
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Primary and secondary osteoarthritis of the shoulder occurs due to destruction of the articular surface of the humeral head and glenoid , Patient mainly presented with pain and decreases in the range of motion . Treatment of shoulder osteoarthritis is often controversial and is typically based on the patient's age, the severity of symptoms, and level of activity, radiographic findings, and medical comorbidities. The new era of management include regenerative therapy ,Platelet-rich plasma (PRP) is one of the regenerative therapy that prove its effect as injections of a concentration of a patient's own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints.

Official Title
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Effect of Platelet Rich Plasma Therapy for Shoulder Osteoarthritis :Double Blinded Randomized Controlled Study

Conditions
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Shoulder Osteoarthritis

Intervention / Treatment
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* Procedure: Injection in the intraarticular space of glenohumeral joint


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient's age: From 21 years. Acute symptoms on a background of at least a 3-month history of chronic pain or swelling of the shoulder joint with radiological confirmed (X-ray or MRI) Mild or moderate osteoarthritis of the shoulder joint according to The Samilson-Prieto classification. Numerical Rating Scale for pain scores greater than five on a 10 scale Exclusion Criteria: Under 21 years of age Severe osteoarthritis according to The Samilson-Prieto classification. (Figure 1) Neuropsychiatric disorders. Immunocompromised patients. Active infection or malignancy at the joint. Pregnancy and breastfeeding. Patients may have thrombocytopenia, bleeding disorders, or on anticoagulant therapy. Shoulder surgery within 3 months or inflammatory arthritis; previous infection of the shoulder joint.

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Injection (study) group<br>This group will receive platelet rich plasma (PRP) injection | Procedure: Injection in the intraarticular space of glenohumeral joint<br>* U/S guided injection of platelet rich plasma (PRP) or normal saline (NS)<br>|
| Placebo Comparator: Control group<br>This group will receive normal saline (NS) injection | Procedure: Injection in the intraarticular space of glenohumeral joint<br>* U/S guided injection of platelet rich plasma (PRP) or normal saline (NS)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in patient's pain score | By using NUMERICAL PAIN SCALE patient will mention them pain score on scale from 1 to 10, where the pain score to be included in the study is 5 and more , we will measure pain score for each patient after 2 weeks from injection ,where decrease of the number from the initial recorded number before injection means improvement. | 2 weeks after each injection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in the range of motion | This out come will be evaluated by physiotherapist using a device called a goniometer. A goniometer is a metal or plastic handheld device with two arms. Numbers representing angular distance are on the device, The physiotherapist measures the initial angular distance before the injection, and after the injection by 2 weeks Normal range of active movement of the shoulder has been specified by the American Academy of Orthopedic Surgeons (AAOS) to be 180° for flexion and abduction and 90° for external rotation. | 2 weeks after each injection |