Effect of platelet-rich plasma on the degenerative rotator cuff tendinopathy according to the compositions

Yeo, Seung Mi; Noh, Soo Jin; Ha, Chul‐Won; Lee, Byung Chan; Lee, Hyo Sun; Kim, Sun Jeong

doi:10.1186/s13018-019-1406-4

Cited by 34 publications

(24 citation statements)

References 59 publications

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“…[ 15 , 16 ] It contains several specific growth factors (such as vascular endothelial growth factor, epidermal growth factor, transforming growth factor-b, and insulin-like growth factor) that can stimulate healing, promote the inflammatory cascade, and accelerate tissue regeneration. [ 16 – 18 ] Recent study [ 19 ] reported that PRP injection play an effective and important role in the treatment of rotator cuff lesions, in cases where physiotherapy has been unsuccessful.…”

Section: Introductionmentioning

confidence: 99%

Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions

Wang¹,

Zhang²,

Ma³

et al. 2021

Medicine

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Background: To explore the effectiveness of platelet-rich plasma (PRP) injection regarding functional recovery, pain relief, and range of motion (ROM) of shoulder compared with the corticosteroid injection in patients with rotator cuff lesions treated non-operatively. Methods: An electronic literature search was performed by 2 authors in the PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant randomized controlled trial (RCTs) that were published up to July 20, 2020. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect sizes. Results: Six RCTs were included in this systematic review. Meta-analysis revealed that corticosteroid injection yielded statistically significant superior functional recovery (SMD = −0.80; 95% CI, −1.42 to −0.18; P = .01) and pain relief (MD = 1.59; 95% CI, 0.30–2.89; P = .02) compared with PRP injection for rotator cuff lesions during the short-term follow-up period. However, at the medium-term and long-term follow-up, no statistically significant difference was identified between the 2 groups. Regarding the ROM of shoulder, no statistically significant difference was found between the 2 groups during the whole follow-up period. Conclusions: The current clinical evidence revealed short-term efficacy of corticosteroid injection and no significant medium- to long-term difference between corticosteroid and PRP injection in the treatment of rotator cuff lesions. Additional studies with longer follow-ups, larger sample sizes, and more rigorous designs are needed to draw more reliable and accurate conclusions.

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Section: Introductionmentioning

confidence: 99%

Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions

Wang¹,

Zhang²,

Ma³

et al. 2021

Medicine

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“…Additionally, although analysis of the composition of PRP was performed, the concentrations of specific growth factors, such as interleukin-1b (IL-1b) and transforming growth factor-b1 (TGF-b1), were not analyzed. Kim et al 22 recently published a study in which cutoff values for these growth factors were presented to predict meaningful improvement in patients with degenerative rotator cuff tendinopathy. Although higher numbers of platelets and leukocytes are associated with an increase in growth factors, 37 analysis of concentrations of specific growth factors in addition to the concentration of platelets and leukocytes in PRP might give more insight in the optimal concentration of PRP for tendon healing.…”

Section: Discussionmentioning

confidence: 99%

“…43,48,51 In the nonoperative treatment of rotator cuff disease, such as partial-thickness rotator cuff tears and tendinopathy, conflicting results have been published about the efficacy of PRP. 3,[20][21][22]39,40,44,45,49 In comparison with corticosteroid injections, however, PRP seems to give superior results in the short term in patients with partial-thickness rotator cuff tears. 45,49 The use of PRP in the treatment of RCCT has never been investigated.…”

mentioning

confidence: 99%

Efficacy of Adjuvant Application of Platelet-Rich Plasma After Needle Aspiration of Calcific Deposits for the Treatment of Rotator Cuff Calcific Tendinitis: A Double-Blinded, Randomized Controlled Trial With 2-Year Follow-up

et al. 2021

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Background: Needle aspiration of calcific deposits (NACD) is a frequently used treatment for rotator cuff calcific tendinitis (RCCT). However, a substantial number of patients experience recurrent or persisting shoulder symptoms after NACD. Purpose: To compare the effects of adjuvant application of platelet-rich plasma (PRP) after NACD (NACP+PRP) with those of conventional NACD with corticosteroids (NACD+corticosteroids) on pain, shoulder function, and quality of life (QoL). Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In a single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic RCCT were randomly allocated to receive NACD+corticosteroids or NACD+PRP. Pain, shoulder function, and QoL were assessed at baseline; 6 weeks; and 3, 6, 12, and 24 months after treatment using a numeric rating scale for pain (NRS); the Constant-Murley score (CMS); the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH); the Oxford Shoulder Score (OSS); and the EuroQol 5-dimension scale (EQ-5D). Additionally, resorption of calcific deposits and the integrity of rotator cuff tendons were assessed by using standard radiographs and ultrasound examination, respectively. The results were analyzed using noninferiority analysis for NRS scores and a mixed model for repeated measures. Results: Eighty patients were included (48 female; mean age, 49 ± 6 years; 41 patients in the NACD+PRP group). Both groups showed improvement of clinical scores at the 2-year follow-up ( P < .001 for all clinical scores). NACD+PRP was found to be noninferior to NACD+corticosteroids with regard to the mean decrease of NRS scores (4.34 vs 3.56; P = .003). Mixed-model analysis showed a significant difference in favor of NACD+PRP (CMS, P < .001; DASH, P = .002; OSS, P = .010; EQ-5D, P < .001). However, clinically relevant differences in favor of NACD+PRP were only seen at the 6-month follow-up for NRS and CMS scores, whereas at the 6-week follow-up a clinically relevant difference in favor of NACD+corticosteroids was found for all clinical scores except for the NRS. Full resorption of calcific deposits was present in 84% of the NACD+PRP group compared with 66% in the NACD+corticosteroids group ( P = .081). In the NACD+PRP group, 10 (24%) patients required a second NACD procedure compared with 19 (49%) patients in the NACD+corticosteroids group ( P = .036). Six complications, of which 5 were frozen shoulders, occurred in the NACD+PRP group compared with 1 complication in the NACD+corticosteroids group ( P = .11). Conclusion: NACD+PRP resulted in worse clinical scores at the 6-week follow-up but better clinical scores at the 6-month follow-up compared with NACD+corticosteroids. At the 1- and 2-year follow-ups, the results were comparable between groups. Furthermore, PRP seemed to reduce the need for additional treatments but was associated with more complications. In conclusion, NACD+corticosteroids had a favorable early effect on pain and function combined with low comorbidity. Thus, it remains the treatment of choice for patients with RCCT. Registration: NCT02173743 (ClinicalTrials.gov identifier).

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“…PRP contains various growth factors and other bioactive molecules, which may regulate the aberrant inflammatory processes, regenerate tissue structures and thus promote tissue healing [ 15 ]. Autologous PRP involves a minimum risk of immune reactions and transmission of infectious diseases, and it has been widely used for the recovery of rotator cuff tendinopathy [ 16 ]. Previously, a RCT conducted by Lin et al [ 17 ] revealed that intra-articular injections of leukocyte-poor PRP can provide clinically significant functional improvement for at least 1 year in patients with mild-to-moderate osteoarthritis of the knee.…”

Section: Introductionmentioning

confidence: 99%

Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis

et al. 2020

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Background This study aimed to evaluate the clinical efficacy of platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA) injection for patients undergoing knee osteoarthritis. Methods We systematically searched electronic databases including PubMed, Embase, Web of Science, and the Cochrane Library on January 23, 2020 to identify relevant studies issued in English languages. The outcomes evaluating the efficacy of knee osteoarthritis (KOA) treatment were Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores (WOMAC pain, function, stiffness, and total scores) at 1, 3, 6, and 12 months; International Knee Documentation Committee (IKDC) scores, Lequesne Index score, Visual Analog Scale (VAS) scores, EQ-VAS scores, and KOOS scores. The pooled data were analyzed by Stata 12.0. Results A total of 20 RCTs were enrolled in the present meta-analysis. The pooled results demonstrated that platelet-rich plasma (PRP) injection reduced pain more effectively than hyaluronic acid (HA) injection at 6-month and 12-month follow-up evaluated by WOMAC pain scores and VAS scores. EQ-VAS in the patients treated with PRP injection was lower than that in patients with HA injection at 12 months. Moreover, the patients with PRP injection had a better function recovery than those with HA injection at 1-month, 3-month, 6-month, and 12-month follow-up, as evaluated by WOMAC function scores. WOMAC total scores showed significant difference at 6-month and 12-month follow-up. The IKDC scores indicated PRP injection was significantly more effective than HA injection at 3 months and 6 months. However, the Lequesne Index scores, KOOS scores, and adverse events did not show any significant difference between groups. Conclusion Intra-articular PRP injection appeared to be more efficacious than HA injection for the treatment of KOA in terms of short-term functional recovery. Moreover, PRP injection was superior to HA injection in terms of long-term pain relief and function improvement. In addition, PRP injection did not increase the risk of adverse events compared to HA injection.

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Effect of platelet-rich plasma on the degenerative rotator cuff tendinopathy according to the compositions

Cited by 34 publications

References 59 publications

Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions

Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions

Efficacy of Adjuvant Application of Platelet-Rich Plasma After Needle Aspiration of Calcific Deposits for the Treatment of Rotator Cuff Calcific Tendinitis: A Double-Blinded, Randomized Controlled Trial With 2-Year Follow-up

Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis

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