Comparison of ultrasound-guided platelet-rich plasma, prolotherapy, and corticosteroid injections in rotator cuff lesions

Sarı, Aylin; Eroğlu, Ali

doi:10.3233/bmr-191519

Cited by 55 publications

(63 citation statements)

References 32 publications

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“…Nine studies [18][19][20][21][22][23][24][25][26] were included in this systematic review. All studies included were prospective [18][19][20][21][22][23][24][25][26][27], all of these were randomized clinical trial except one. A total of 494 shoulders were analyzed; of these 232 underwent infiltration with corticosteroids, 90 with PRP and 47 with glucose prolotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies compared the usage of corticosteroids and placebo [18][19][20][21], three studies compared corticosteroids and PRP [22,23,26], one study compared corticosteroids with prolotherapy [24] and one study compared corticosteroids with all the other techniques mentioned above [26]. Each study considered different dosages for each drug.…”

Section: Interventionsmentioning

confidence: 99%

“…The principal outcomes of interest included pain reduction, which was evaluated comparing the scales used in the studies (VAS-Visual Analog Scale-scale [18][19][20][21][22][23][25][26][27] and Likert scale [24]) and functional improvement of the shoulder. Outcomes considered to assess shoulder function were: Constant Score, ASES (American Shoulder and Elbow Score), WORC (Western Ontario Rotator Cuff index), DASH (The Disability of the Arm, Shoulder and Hand), SST (Simple Shoulder Test), SDQ (Strenghts and Difficulties Questionnaire) and ROM (Range Of Motion).…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Two studies analyzed the effects of prolotherapy [24,26]. The mean values of VAS, ASES and WORC obtained from the analysis are at the three follow up times respectively: 4.37 ± 1.…”

Section: Prolotherapymentioning

confidence: 99%

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The Efficacy of Injections for Partial Rotator Cuff Tears: A Systematic Review

Sanctis

Franceschetti

Dona

et al. 2020

JCM

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(1) Background: Even though rotator cuff tears are the most frequent tendon injuries in adults, the effectiveness of conservatively treated partial-thickness tears still remains a matter of debate. The purpose of this review is to compare corticosteroid injections to other drugs in the treatment of partial rotator cuff tears, focusing on the effectiveness of this therapeutic modality in terms of pain and shoulder functionality. (2) Methods: A systematic electronic search was performed using the PubMed (MEDLINE), EMBASE and Cochrane Library databases. All studies comparing the use of corticosteroids and other infiltrative techniques in the treatment of partial lesions (excluding studies that considered subacromial impingement as inclusion criteria) were pooled, data were extracted and statistically analyzed. (3) Results: Nine studies were included in this systematic review. Those studies, composed by a total of 494 shoulders treated, have been published from 1985 to 2019. All compared techniques have shown a significant improvement over baseline condition. PRP (Platelet Rich Plasma) injections have been shown to be significantly more effective in both functional and pain control only in the long term. (4) Conclusions: None of the techniques prevail indisputably on the others. Anyway, the treatment of partial rotator cuff tears with PRP injections seems to lead to significantly better outcomes in terms of pain and shoulder function in long term follow up. Whereas in short and medium term follow up, PRP injections was superior only in terms of shoulder function. The small number of studies on prolotherapy did not enable us to provide an opinion on the outcomes of this technique.

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Section: Resultsmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

“…Two studies analyzed the effects of prolotherapy [24,26]. The mean values of VAS, ASES and WORC obtained from the analysis are at the three follow up times respectively: 4.37 ± 1.…”

Section: Prolotherapymentioning

confidence: 99%

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The Efficacy of Injections for Partial Rotator Cuff Tears: A Systematic Review

Sanctis

Franceschetti

Dona

et al. 2020

JCM

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“…In 14 patients in the dry needling group who 448 completed the six-month follow-up, no partial tears of 449 the supraspinatus improved to tendinosis and one case 450 of tendinosis improved to normal status. One study by Sari et al evaluated 120 patients treated 454 a single ultrasound-guide injection into the subacro-455 mial bursa with either PRP, prolotherapy (20% dex-456 trose), triamcinolone, or 1% lidocaine [49]. There were 457 30 patients in each of the four groups, and all were 458 given a shoulder rehabilitation program to complete 459 for 6 weeks.…”

Section: Prp Versus Salinementioning

confidence: 99%

Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review

Robinson

Eng

Makovitch

et al. 2021

BMR

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BACKGROUND: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed “low risk of bias or good quality”. Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.

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

Adra

Ghazal

Nakanishi

et al. 2022

Journal Orthopaedic Research

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Platelet-rich plasma (PRP) is an alternative to corticosteroid (CS) injections in managing rotator cuff disease. This meta-analysis investigated differences between PRP and CS for function and pain scores in significance and minimal clinical important difference (MCID). A literature search of Ovid Cochrane Library, Medline, Embase, Epub, and Scopus was conducted from inception to October 28, 2021.Eligible studies reported patients older than 18 years with a diagnosis of rotator cuff disease. This review was registered in PROSPERO (ID: CRD42021278740). Twelve studies met eligibility criteria (n = 639) of patients receiving either PRP or CS. At short-term follow-up, a difference favored CS compared to PRP in baseline change for disability of arm, shoulder, and hand (DASH) score (MD = −5.08, 95% CI: −8.00, −2.15; p = 0.0007; I 2 = 0%) and simple shoulder test (SST) (MD = 1.25, 95% CI: 0.33, 2.18; p = 0.008; I 2 = 0%). At intermediate follow-up, a difference favored PRP to CS baseline change of the DASH score (MD = 3.41, 95% CI: 0.67, 6.15; p = 0.01; I 2 = 0%). At medium-term, a difference favored PRP to CS baseline change of the American Shoulder and Elbow Surgeons Shoulder (ASES) score (MD = −4.42, 95% CI: −8.16, −0.67; p = 0.02; I 2 = 0%). Both treatments achieved individual MCID for each score. Despite favoring CS at short-term follow-up and PRP at intermediate-and medium-term follow-up, functional and pain scores did not demonstrate any clinical difference between the two treatment modalities in management of rotator cuff disease at all follow-up periods.

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Comparison of ultrasound-guided platelet-rich plasma, prolotherapy, and corticosteroid injections in rotator cuff lesions

Cited by 55 publications

References 32 publications

The Efficacy of Injections for Partial Rotator Cuff Tears: A Systematic Review

The Efficacy of Injections for Partial Rotator Cuff Tears: A Systematic Review

Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review

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

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