Platelet-rich plasma injection in a patient with adhesive capsulitis due to chronic kidney disease.

Adhesive capsulitis is a common problem in patients with chronic kidney disease. Patients suffer from joint stiffness and painful joint movement.Conservative treatments consist non-steroid antiinflamatory drugs, intraarticular injections and physical therapy. Newer approches such as platelet-rich plasma injections (PRP) also can be applied but there is little evidence for the effectiveness of PRP in patients with adhesive capsulitis. A 70 year-old woman, receives dialysis treatment admitted to our out-patient clinic with stiffness and pain in her right shoulder. Her diagnosis was confirmed with MRI as adhesive capsulitis., PRP injectionn began to be applied as planned; 3 times, 15 days between each injection. Visual analog scale (VAS), disabilities of the arm, shoulder and hand questionnare (DASH) and range of motion (ROM) of her right shoulder were evaluated before the procedure process. ROM, DASH and VAS were assessed every 2 weeks after each injection. At the last assesment average ROM increased on flexor, abductor and internal rotator sides. It was evaluated 90° for flexion, 90° for abduction and 30° for internal rotation. However, she didn't report any improvement for function and pain based on DASH and VAS.