Platelet-Rich plasma for adhesive capsulitis: An umbrella review of effects on pain, function, and range of motion

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Abstract
Background: Adhesive capsulitis is a common and disabling shoulder condition with substantial impact on pain and function, yet the role of platelet-rich plasma (PRP) injections remains uncertain. Objective: This umbrella review aimed to synthesize the evidence on the effects of PRP on pain, shoulder range of motion, and function in adults with adhesive capsulitis. Methods: A search of MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL was conducted from inception to June 2025. Systematic reviews and meta-analyses were included and appraised using the Joanna Briggs Institute umbrella review methodology, and only reviews meeting predefined methodological quality criteria were included in the synthesis. The review was registered in PROSPERO (CRD420251024935). Results: Six systematic reviews meeting the predefined critical methodological criteria were included. Across reviews, PRP was generally associated with greater improvements in pain, shoulder range of motion, and functional outcomes at intermediate- and long-term follow-up compared with control treatments. In contrast, short-term outcomes were generally comparable between PRP and control treatments. Reported adverse events were infrequent and typically mild and transient. Conclusion: PRP appears to be associated with beneficial effects at intermediate and longer follow-up compared with commonly used interventions. However, the overall strength of evidence remains limited by heterogeneity in PRP protocols, comparator interventions, and outcome reporting, while incomplete and variable reporting of adverse events precludes firm conclusions regarding safety. These findings suggest that PRP may represent a adjunct treatment-option in adhesive capsulitis when longer-term outcomes are prioritized, although standardization of PRP protocols and further high-quality research are needed.

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