Comparison of a Platelet-Rich Plasma Injection and a Conventional Steroid Injection for Pain Relief and Functional Improvement of Partial Supraspinatus Tears

Abstract

Background: Partial supraspinatus tendon tears have frequently been treated using a subacromial corticosteroid injection or surgery. The clinical use of a platelet-rich plasma (PRP) injection is an alternative treatment method for the condition, despite the paucity of evidence of its efficacy. Purpose: To compare pain relief, functional improvement, and complications after an intratendinous PRP injection versus a subacromial corticosteroid injection for partial supraspinatus tears. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 32 patients with partial supraspinatus tears were randomly assigned to receive a leukocyte-poor PRP (LP-PRP) injection or a corticosteroid injection. One patient withdrew from the PRP group, leaving 15 patients in the PRP group and 16 patients in the corticosteroid group. The ultrasound-guided procedures were performed by a single experienced pain physician. Pain relief and functional improvement were evaluated using the visual analog scale (VAS) and the Oxford Shoulder Score (OSS), respectively. Treatment efficacy and complications were documented, and the 2 groups were compared at 1- and 6-month follow-up. Results: There were no differences in VAS and OSS scores between the PRP and corticosteroid groups at 1-month follow-up. However, the PRP group had better scores than the corticosteroid group had on both the VAS and OSS at 6-month follow-up (VAS: 14.5 ± 15.4 vs 37.5 ± 24.9, respectively; OSS: 16.2 ± 3.9 vs 25.0 ± 10.2, respectively; P < .01 for both). Both groups showed significant improvement in VAS and OSS scores from before treatment to 1-month follow-up (mean difference, 35.67 and 11.47 points, respectively, for the PRP group; mean difference, 29.69 and 11.13 points, respectively, for the corticosteroid group; P < .01 for all). The VAS and OSS scores did not change significantly at 6-month follow-up in the corticosteroid group; however, the PRP group showed continued improvement in both VAS and OSS scores between 1- and 6-month follow-up (mean difference, 15.87 and 7.40 points, respectively; P < .01 for both). There were no complications in either group. Conclusion: An injection using either a corticosteroid or LP-PRP resulted in a similar reduction in pain and improvement in function at 1 month in patients with a partial supraspinatus tear. However, PRP showed superior benefits over the corticosteroid at 6-month follow-up.

Platelet‐rich plasma versus corticosteroid injections in the management of patients with rotator cuff disease: A systematic review and meta‐analysis

“…The baseline VAS scores along with their change from base‐line can be found in Table 4 . At short‐ and intermediate‐term follow‐up, the change from baseline was comparable between the CS and PRP groups and no difference was observed (short‐term: MD = −0.30, 95% CI: −1.40, 0.08; p = 0.59; I 2 = 89% 12 , 26 , 28 , 32 , 34 ) (Intermediate‐term: MD = 0.28, 95% CI: −0.71, 1.28; p = 0.58; I 2 = 84% 26 , 27 , 28 , 31 , 32 ). At medium‐term follow‐up, no difference in the change of VAS score from base‐line was observed between the PRP and CS groups (MD = 0.39, 95% CI: −1.84, 2.62; p = 0.73; I 2 = 97% 12 , 28 , 32 , 34 ).…”

“…CS administration generally can cause local skin manifestations such as rash or hypopigmentation which are considered to be minor adverse effects. 43 There exist reviews that mention serious side effects upon local CS injection such as subcutaneous tendon ruptures 42,44 However, such an event is mainly Thepsoparn et al 34 Leukocyte-poor 1 Yes Posterolateral at tendon site PRP was prepared using the ACP Double Syringe System (Arthrex).…”

Subacromial Bursa: A Neglected Tissue Is Gaining More and More Attention in Clinical and Experimental Research

“…In the case of rotator cuff tendinopathy, subacromial injections of platelet-rich plasma (PRP) may also be justified by a possible beneficial effect of the biological components of PRP. PRP’s involvement in pain reduction is likely, but details of its benefits are still under debate [ 35 , 36 , 37 , 38 ]. Furthermore, the effectiveness of hyaluronic acid injections, with proposed anti-inflammatory effects [ 39 ], were investigated in placebo controlled clinical trials, but could not compete with the effects of corticosteroids in the treatment of subacromial bursitis [ 40 , 41 ].…”

Platelet-Rich Plasma Injection in Non-Operative Treatment of Partial-Thickness Rotator Cuff Tears: A Systematic Review and Meta-Analysis

“…A total of 641 patients were included (318 patients in the PRP group and 323 in the control group). The control groups in the included studies were as follows: 3 studies used placebo (saline or dry needle) (20)(21)(22); and 8 used conservative treatments (corticosteroids injection or physical therapy) (23)(24)(25)(26)(27)(28)(29)(30). Ten studies prepared PRP via centrifugation.…”