Platelet-rich plasma demonstrates significantlybetter short-term pain relief and functionalimprovement in patients with partial-thicknessrotator cuff tears or tendinopathy:a double-blindrandomized controlled trial
Abstract
Purpose To compare the efficacy of a single ultrasound-guided platelet-rich plasma (PRP) injection versus corticosteroid (CS) injection for pain relief and functional improvement in patients with partial-thickness rotator cuff tears (PTRCTs) or rotator cuff tendinopathy. Methods This double-blind randomized controlled trial enrolled patients with ultrasound- or magnetic resonance imaging–proven PTRCTs or tendinopathy who had failed conservative treatment. Participants were randomly allocated to receive either a leukocyte-poor PRP injection or a standard CS injection (triamcinolone acetonide), both performed under ultrasound guidance. Patient-reported outcomes, including the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Western Ontario Rotator Cuff Index (WORC) score, were assessed at baseline, 6 weeks, 3 months, and 12 months. The primary outcome was the change in VAS score. Secondary outcomes included changes in ASES and WORC scores, as well as rates of treatment failure and conversion to surgery. Results Ninety-nine patients (47 PRP, 52 CS) completed 12-month follow-up. Baseline demographic characteristics were similar between groups; however, the PRP group had significantly worse baseline VAS (46.0 vs 34.7, P = .01), ASES (53.9 vs 61.8, P = .02), and WORC (42.2 vs 49.5, P = .03) scores. At 3 months, the PRP group demonstrated superior improvement in VAS (−13.6 vs +0.4, P = .03), ASES (+13.0 vs +2.9, P = .02), and WORC (+16.8 vs +5.8, P = .03) scores. No significant between-group differences were observed at 6 weeks or 12 months. Rates of treatment failure (P = .31) and conversion to surgery (P = .83) were comparable. Conclusions Both ultrasound-guided PRP and CS injections improved pain and function in patients with PTRCTs or tendinopathy. PRP provided significantly better short-term (3-month) pain relief and functional improvement, but this advantage was not sustained at 12 months.