Efficacy comparison of sodium hyaluronate, corticosteroids, and autologous platelet-rich plasma in the treatment of primary frozen shoulder.

Objectives: Primary frozen shoulder is a shoulder joint disease that severely impacts the quality of life of patients, and intra-articular injection is a common treatment method. This study aims to evaluate and compare the therapeutic effects of sodium hyaluronate (SH), corticosteroids (CS), and autologous platelet-rich plasma (PRP) in the treatment primary frozen shoulder.

Methods: A total of 117 patients diagnosed with primary frozen shoulder and treated with a single injection of SH, CS, or PRP into the glenohumeral joint under ultrasound guidance at the Third Xiangya Hospital of Central South University from January 1, 2020, to December 31, 2022, were included in the study. The patients were divided into a SH group, a CS group, and a PRP group. Clinical data of patients, including Visual Analogue Scale (VAS) pain score, range of motion, Constant score, and Disabilities of Arm, Shoulder, and Hand (DASH) score were collected before treatment and at 1, 3, and 6 months after treatment. The efficacy of these 3 intra-articular injection therapies for primary frozen shoulder was compared.

Results: Compared with the baseline, the SH, CS, and PRP groups all showed significant improvements in shoulder VAS pain scores, range of motion, Constant scores, and DASH scores at 6 months after treatment (all P<0.05). Compared with the SH and PRP groups, the CS group showed better VAS pain score, range of motion, Constant score, and DASH score at 1 month after treatment (all P<0.05). However, the VAS pain score, range of motion, Constant score, and DASH score in the PRP group were better than those in the SH and CS groups at 6 months after treatment (all P<0.05).

Conclusions: A single ultrasound-guided injection of SH, CS, or PRP into the glenohumeral joint can significantly improve pain degree, range of motion, and function in patients with primary frozen shoulder. Among these 3 injection therapies, CS may provide better short-term efficacy, while PRP may offer better long-term outcomes.