Purpose: The purpose of this study was to perform a randomized controlled trial, comparing platelet-rich plasma (PRP) to standard corticosteroid (CS) in providing pain relief and improved function in patients with rotator cuff tendinopathy and partial thickness rotator cuff tears (PTRCT).

Methods:This double-blind randomized-controlled trial enrolled patients with ultrasound or MRI proven PTRCT to either an ultrasound-guided PRP or CS injection. Patients completed patient reported outcomes at baseline, 6 weeks, 3 and 12 months post-injection. The primary outcome was improvement in visual analog scale for pain (VAS). Secondary outcomes included change in American Shoulder Elbow Surgeons (ASES) and Western Ontario Rotator Cuff index (WORC) scores. Failure of treatment was defined by subsequent injection, consent to surgery or operative intervention.

Results:99 patients (47 in the PRP and 52 in the CS groups) were followed to 12 months post-injection. There were no differences in baseline patient demographics including age, sex or duration of symptoms. Despite randomization, patients in the PRP group had worse baseline VAS (46.0 vs. 34.7, p=0.01), ASES (53.9 vs. 61.8, p=0.02) and WORC (42.2 vs. 49.5, p=0.03) scores. At 3 months post-injection, the PRP group had superior improvement in VAS (-13.6 vs. 0.4, p=0.03), ASES (13.0 vs. 2.9, p=0.02) and WORC (16.8 vs. 5.8, p=0.03) scores. There were no differences in patient reported outcomes at 6 weeks or 12 months. There was no difference in failure rates (p=0.31) or conversion to surgery (p=0.83) between groups.

Conclusions:Patients with PTRCTs or tendinopathy experienced clinical improvement in pain and patient-reported outcome scores after both ultrasound-guided CS and PRP injections. Patients who received PRP obtained superior improvement in pain and function at short-term follow up (3 months). There was no sustained benefit of PRP over CS at longer-term follow-up (12 months).

Level of evidence:Level 1, Randomized controlled trial.

Continued here:
Platelet Rich Plasma in Patients with Partial Thickness Rotator Cuff Tears or Tendinopathy Leads to Significantly Improved Short-Term Pain Relief and...