Clinical study on betamethasone combined with platelet-rich plasma for frozen shoulder

Objective: Under the support of visual ultrasound technology, this study investigates the efficacy of the combination of betamethasone and platelet-rich plasma (PRP) injections for the precise treatment of frozen shoulder. The findings aim to inform clinical practice. Methods: A total of 84 patients with frozen shoulder who visited the outpatient department of a tertiary Class A hospital between January 2021 and June 2023 were selected. They were randomly assigned to receive either local betamethasone injection guided by visual ultrasound technology or combined betamethasone and PRP injection for precise treatment. The betamethasone local injection group comprised 42 patients, while the combined betamethasone and PRP injection group comprised 42 patients. The application of visual ultrasound technology identifies and marks the lesion site. Under ultrasound guidance, a posterior approach is used to puncture into the joint capsule space between the humeral head and glenoid labrum. Following successful puncture, drug injection therapy is administered. Shoulder joint pain levels and shoulder joint function were compared between the two groups at baseline, 6 weeks post-treatment, and 12 weeks post-treatment. Blood glucose levels were monitored at baseline, 1 day post-treatment, and 3 days post-treatment. Adverse reactions, including rash, abnormal liver function, gastrointestinal reactions, and dizziness/headache, were observed in this study. Results: After 6 weeks and 12 weeks of treatment, the visual analogue scale (VAS) scores for shoulder pain severity and shoulder function were 3.62 ± 1.03 and 1.03 ± 0.25, respectively, in the combined betamethasone and PRP injection group. In the betamethasone local injection group, these scores were 4.56 ± 1.31 and 1.54 ± 0.32, respectively. Comparisons between the two groups yielded p values of .001 and < .001, indicating statistically significant differences. Constant-Murley Shoulder Function Score (CMS) results for the combined betamethasone and PRP injection group were 50.37 ± 6.23 and 80.72 ± 10.69, respectively. For the betamethasone local injection group, the scores were 46.85 ± 6.11 and 73.54 ± 8.23, respectively. Comparing the two groups, the p-values were .011 and < .001, respectively, indicating statistically significant differences. Comparison of blood glucose levels between the two groups: After 1 day and 3 days of treatment, fasting blood glucose levels in the combined betamethasone and PRP injection group were 5.67 ± 0.14 and 5.69 ± 0.13 mg/dL, respectively, while those in the betamethasone local injection group were 6.29 ± 0.35 and 6.35 ± 0.38 mg/dL, respectively. Compared between the two groups, the p-values were < .001 and < .001, respectively, indicating statistically significant differences. 2-hour postprandial blood glucose levels at 1 day and 3 days post-treatment were 6.85 ± 0.25 and 6.87 ± 0.28 mg/dL in the combined betamethasone and PRP injection group, and 8.34 ± 0.21 and 8.49 ± 0.34 mg/dL in the betamethasone local injection group. Comparisons between the two groups yielded p values of < .001 and < .001, respectively, indicating statistically significant differences. The incidence of adverse reactions in the combined betamethasone and PRP injection group was 11.90%, including 1 case of rash, 1 case of abnormal liver function, 2 cases of gastrointestinal reactions, and 1 case of dizziness and headache. The adverse reaction incidence rate in the betamethasone local injection group was 21.43%, including 2 cases of rash, 2 cases of abnormal liver function, 3 cases of gastrointestinal reactions, and 2 cases of dizziness and headache. Comparing the two groups, p > .05, indicating no statistically significant difference. Conclusions: Compared with the betamethasone local injection group, the combined betamethasone and PRP injection group demonstrated lower VAS scores and higher CMS scores at 6 and 12 weeks post-treatment. Additionally, fasting blood glucose and 2-hour postprandial blood glucose levels were lower at 1 and 3 days post-treatment. There was no difference in the incidence of adverse reactions between the two groups. Ultrasound-guided injection of betamethasone combined with PRP demonstrates effective treatment for frozen shoulder and warrants further clinical application.