Comparison of PRP injection, corticosteroid injection and physical treatment effectiveness in subacromyal impingement syndrome treatment

The aim of our study is investigated by the efficacy of PRP injection, corticosteroid injection and physical therapy at pain, shoulder functions and quality of life in the treatment of patients with subacromial impingement syndrome (SIS) and compare these activities to each other. The study was included 90 patients who were diagnosed with stage 2 of SIS. The patients were randomized and divided into three groups. That first group into the subacromial space of the affected shoulder have PRP injection, the second group of subacromial space have corticosteroid injection, the third group have 10 sessions of physical therapy 5 times a week (TENS + ultrasound + hot pack) were administered at the same intervals. However, a total of 8 week exercises of joint range of motion, codman, stretching and isotonic strengthening exercises were applied to all groups. The visual analogue scale (VAS) tests were used to determinate patients' shoulder pain with resting and moving session; Shoulder Disability Questionnaire (SDQ), Quick Disabilities of the Arm, Shoulder and Hand Score (Quick DASH), The University of California and Los Angeles Rating Score (UCLA) tests were evaluated to assess the functional status of patients. The overall quality of life were analyzed by a generic scale named Short form 36 (SF-36). At the end of our study, all three groups of patients improved on all scores compared to before treatment. In comparison between the groups, PRP injection therapy were higher than corticosteroid injection and physical therapy on the 8th week Brief DASH, UCLA, VAS, motion VAS, SF-36 pain subgroup scores. In conclusion, subacromial PRP injection, subacromial steroid injection and physical therapy modalities were found to be effective in the treatment of SIS, and good postoperative course was observed at 3th and 8th weeks. On the other hand, we think that physical therapy and exercise should be preferred in the treatment of SIS due to non-side effect, cheap and noninvasive properties. KEYWORDS, Subacromial impingement syndrome, platelet rich plasma injection, corticosteroid injection, physical therapy, exercise