Subacromial Injection of Allogeneic Platelet Rich Plasma (PRP) for Shoulder Impingement Syndrome

Allogeneic Platelet-Rich Plasma Versus Corticosteroid Injection for the Treatment of Rotator Cuff Disease: A Randomized Controlled Trial

The purpose of this study is to investigate the efficacy of allogeneic PRP in patients with subacromial impingement disease

Inclusion Criteria:

• Male or female 18 years of age and older

• Patients who have unilateral shoulder pain.

• Patients who have had pain at least for 3 months

• To be included in the study- participants are required to have a & b.(mentioned below)

  1. Pain with one of the two tests

     • Neer's sign: passive overpressure at full shoulder flexion with the scapula fixed
     • Hawkins test: passive internal rotation at 90 degree of shoulder flexion in the scapular plane and in progressive degree of horizontal adduction

  2. Pain with one of the two tests

     • Painful arc: active shoulder abduction
     • Jobe's test: The examiner passively elevates the patient's shoulder to 90 degrees of abduction with internal rotation. The examiner then applies a downward pressure against the arm

Exclusion Criteria:

• Patients who received any drug by subacromial injection for treatment within 3 months prior to this enrollment.
• Patients who have a history of shoulder trauma including dislocation- subluxation- and fracture- breast cancer- or surgery around shoulder- neck and upper back
• Patients who have a isolated acromioclavicular joint pathology
• Patients who have a full-thickness rotator cuff tear (evidenced by MR or ultrasonography)
• Patients with symptomatic cervical spine disorders
• Patients who have a History of allergic adverse reactions to corticosteroid
• Patients are unable to give informed consent to participate in the study
• Patients are unable to come into the clinic for regular follow-up
• Patients with adhesive capsulitis- acromioclavicular arthropathy- polyarthritis- infectious arthritis- rheumatoid arthritis or diagnosed fibromyalgia
• Patients with concurrent bilateral shoulder pain
• Patients with neurological deficit
• Patients who have severely abnormal radiological findings including malignancy, severe osteoarthritis of the glenohumeral joint, severe skeletal abnormalities decreasing the subacromial space and etc.
• Presence of shoulder pain with limitation of both active and passive movements of the glenohumeral joint of 25% in at least 2 directions (abduction, flexion, external rotation, internal rotation), as compared with the contralateral shoulder or with normal values
• Patients with Diabetes mellitus
• Patients taking anticoagulants
• Pregnant women or lactating mothers
• Patients who are difficulty participating in data collection due to communication problem and serious mental illness
• Patients with serious condition which can affect this study such as severe cardiovascular diseases- renal diseases- liver diseases- endocrine diseases- and cancers