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PRP Injection of the Arthritic Glenohumeral Joint is Safe, Effective, and Avoids Joint Replacement in Many Patients at 2-8 year Follow-Up

Purpose: Platelet Rich Plasma (PRP) injection has been shown to benefit knee osteoarthritis (OA). We are unaware of any published studies evaluating efficacy for glenohumeral shoulder OA. We hypothesized that PRP would be safe, would improve glenohumeral OA, and would result in joint replacement avoidance in many patients.

Methods and Materials: A total of 45 shoulders with clinical and radiographic OA were included in the study. Patients received a single injection of PRP into the glenohumeral joint from a posterior approach under ultrasound guidance. Shoulders were divided into group 1 which had 0-1 mm of joint space on the Grashey (true AP) view of the shoulder and group 2 which had at least 2mm of joint space on the Grashey view. Outcomes included safety, survivorship/joint replacement avoidance, DASH, SANE, and global improvement percentage. Follow up was performed at 6 months, 1 year, and at least 2 years post treatment.

Results: No serious adverse events occurred as a result of the treatment. Joint replacement avoidance percentage was 92.6, 84, and 72 for group 1 and 100, 100, and 93.3 for group 2 at 6, 12, and 24 months, respectively. Global Improvement percentage was 31.3, 26.3, and 27.4 for group 1 and 57.2, 37.4, and 47.3 for group 2 at 6, 12, and 24 months, respectively. The global improvement difference between group 1 and 2 was statistically significant at 6 months. Sane scores were improved at 6 months with greater improvement at 1 year which was sustained at two to eight year follow up. Short DASH scores improved by 6.5 points at two year follow up.

Conclusion: PRP injection of the arthritic glenohumeral joint is safe, effective for most patients, and results in a high rate of survivorship/joint replacement avoidance even in bone on bone shoulders at two to eight year follow up.