Allogenic Platelet-Rich Plasma for the Treatment of Adhesive Capsulitis

Abstract

Adhesive capsulitis (AC) is a common shoulder disorder leading to pain and restricted range of motion (ROM) and affects the patient's activities of daily living (ADL) and overall quality of life (QoL). Conservative therapies are prioritized, resorting to surgical intervention only when necessary. Unfortunately, these modalities have limitations and do not address the underlying pathological cause of AC. The use of autologous biologics, such as platelet-rich plasma (PRP), has evolved and shown promise for managing musculoskeletal (MSK) injuries, including AC. However, subpar functional outcomes have led clinicians to question the long-term efficacy of autologous PRP. To circumvent this, the possibility of utilizing a standardized and well-characterized allogenic PRP for AC has been explored. In this manuscript, we qualitatively present in vitro, pre-clinical, clinical, and ongoing studies investigating the varied applications of allogenic PRP for the management of AC. The results demonstrated that allogenic PRP acts in a pleiotropic manner and decreases pro-inflammatory cytokines only in the inflammatory condition. In addition, the administration of allogenic PRP is safe and potentially efficacious, in terms of reducing pain and improving range of motion, shoulder strength, and function, in non-surgical management of AC. Nonetheless, more pre-clinical studies and adequately powered, multicenter, prospective, non-randomized, and randomized controlled trials with longer follow-up are warranted to further establish the safety and efficacy of allogenic PRP and justify its routine clinical use.

Hyperacute Serum and Knee Osteoarthritis

“…Over the last decade, there has been a prominent rise in the use of orthobiologics, including autologous peripheral blood-derived orthobiologics (APBO) for musculoskeletal regenerative medicine [4][5][6]. Plateletrich plasma (PRP) is the most extensively used APBO, yet its effectiveness remains controversial, ascribed to a lack of standardized preparation protocol, inter-and intra-patient variables, etc.…”

“…Plateletrich plasma (PRP) is the most extensively used APBO, yet its effectiveness remains controversial, ascribed to a lack of standardized preparation protocol, inter-and intra-patient variables, etc. [4][5][6]. Clinicians and scientists have investigated the utilization of platelet-rich fibrin (PRF) to circumvent the limitations posed by PRP, attributed to its ability to secrete growth factors and cytokines for a longer duration compared to PRP; however, its three-dimensional (3D) structure deters its administration as an injectable [7][8][9].…”