Glenohumeral (Shoulder Joint) Arthritis

CAUSES

• Age-related cartilage wear
• Prior shoulder dislocation or instability
• Long-standing rotator cuff tearing, which changes joint mechanics
• Inflammatory arthritis affecting the shoulder

SYMPTOMS

• Deep, aching shoulder pain, often worse with activity and at night
• Progressive stiffness, especially reaching overhead or behind the back
• Grinding sensation with movement

IMAGING WE’LL TYPICALLY ORDER

Shoulder X-ray can show the problem and grade the arthritis. MRI can be added if rotator cuff integrity needs to be assessed.

CAN PRP HELP?

In the RCTs available, PRP outperformed cortisone injection over the long term, making this a reasonable option for patients who want to delay surgery or repeated cortisone injections.

Leukocyte Preparation: Leukocyte-Poor

Dosing: Series of 2-3 injections

Target Platelet Dose in Studied Protocols: 3.1–9.3 billion platelets across the positive trials.

ASPN 2024 CONSENSUS GUIDELINE

ASPN grades glenohumeral OA Level I, Grade B — a step up from how this indication is sometimes described in general shoulder-pathology reviews as merely “investigational.” The caveat the guideline itself makes: this Grade B rests on a genuinely small number of available RCTs, so it’s high-quality evidence from a limited pool of trials rather than a large, deep literature like knee OA.

Sources: D’Souza et al. (ASPN Consensus), Journal of Pain Research, 2024 · Yamamoto et al., Journal of ISAKOS, 2023

FREQUENTLY ASKED QUESTIONS

Is PRP an alternative to shoulder replacement surgery?

It can be, for the right patient. Studies show PRP working better than cortisone over the long run, which makes it a reasonable option if you want to delay surgery.

How many PRP injections for shoulder arthritis?

Most plans use two to three shots.

What does shoulder arthritis feel like?

You may notice a deep ache that is worse with activity and at night, stiffness reaching overhead or behind your back, and sometimes a grinding feeling.

Can PRP help me put off shoulder replacement surgery?

It’s a reasonable option to discuss for that goal. In the RCTs available, PRP outperformed corticosteroid injection over the long term for GH joint arthritis, making it worth considering for patients who want to delay surgery or repeated steroid injections.

What PRP protocol is used for shoulder arthritis?

Leukocyte-poor PRP, typically as a series of two to three injections, with platelet doses in the positive trials ranging from about 3.1 to 9.3 billion

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