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

Wang, Chenglong; Zhang, Zhuo; Ma, Yan; Liu, Xiang-Ji; Zhu, Qingsan

doi:10.1097/md.0000000000024680

Cited by 16 publications

(14 citation statements)

References 55 publications

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“…21 The finding in our sample that the majority of outcomes were negative for PRP in the treatment of rotator cuff lesions, Achilles tendinopathy, and fractures is also in line with lack of current evidence for these PRP uses. 75,83,102 Finally, although there were no clinical studies on PRP for plantar fasciitis within our top 50 most cited articles, it should be noted that there is emerging evidence of greater efficacy for PRP compared with corticosteroids. 42 However, the overall consensus continues to state that PRP is currently an experimental therapy and thus requires proper patient education regarding risks and benefits.…”

Section: Discussionmentioning

confidence: 97%

Assessment of Characteristics and Methodological Quality of the Top 50 Most Cited Articles on Platelet-Rich Plasma in Musculoskeletal Medicine

Bugarin

Schroeder

Shi

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: The wide range of clinical applications and controversial scientific evidence associated with platelet-rich plasma (PRP) therapy in musculoskeletal medicine requires an examination of the most commonly cited studies within this field. Purpose: To identify the 50 most cited articles on PRP, assess their study design, and determine any correlations between the number of citations and level of evidence (LoE) or methodological quality. Study Design: Cross-sectional study. Methods: The Web of Science database was queried to identify the top 50 most cited articles on PRP in orthopaedic surgery. Bibliometric characteristics, number of citations, and LoE were recorded. Methodological quality was evaluated using the Modified Coleman Methodology Score (MCMS), Methodological Index for Non-randomized Studies (MINORS), and Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO). The Pearson correlation coefficient and Spearman correlation coefficient ( r S) were used to determine the degree of correlation between the number of citations or citation density and LoE, MCMS, MINORS score, and MIBO score. Student t tests were performed for 2-group comparisons. Results: The top 50 articles were published between 2005 and 2016 in 21 journals. The mean number of citations and citation density were 241 ± 94 (range, 151-625) and 23 ± 8, respectively, and the mean LoE was 2.44 ± 1.67, with 15 studies classified as LoE 1. The mean MCMS, MINORS score, and MIBO score were 66.9 ± 12.6, 16 ± 4.7, and 12.4 ± 3.7, respectively. No correlation was observed between the number of citations or citation density and LoE, MCMS, MINORS score, and MIBO score. A significant difference ( P = .02) was noted in LoE in articles from the United States (3.56 ± 1.7) versus outside the United States (2 ± 1.5). Seven of the 8 in vivo studies were published between 2005 and 2010, whereas 19 of the 25 clinical outcome investigations were published between 2011 and 2016. Studies that were published more recently were found to significantly correlate with number of citations ( r S = –0.38; P = .01), citation density ( r S = 0.36; P = .01), and higher LoE ( r S = 0.47; P = .01). Conclusion: The top 50 most cited articles on PRP consisted of high LoE and fair methodological quality. There was a temporal shift in research from in vivo animal studies toward investigations focused on clinical outcomes.

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Section: Discussionmentioning

confidence: 97%

Assessment of Characteristics and Methodological Quality of the Top 50 Most Cited Articles on Platelet-Rich Plasma in Musculoskeletal Medicine

Bugarin

Schroeder

Shi

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…These findings are consistent with other studies [ 60 , 79 ]. Different systematic reviews have shown that steroid injection had a quick recovery in reducing the symptoms than PRP, which has a slower improvement but long-term permanent effect [ 50 , 80 ]. Yang et al, 2017 found that the PRP is better than steroid injection for long-term pain reduction in plantar fasciitis, but there was no noticeable observed field difference between short- and intermediate-term effects [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…It needs six to eight weeks for full activities after injection [82]. Steroids lack this property and interrupt the inflammatory and immune cascade, which is short-lived [80,83]. Ang et al, 2019 found in the context of lateral epicondylitis that corticosteroid relieves acute pain but not in the long term, which may be due to the short half-life of the steroid [37].…”

Section: Discussionmentioning

confidence: 99%

Effect of platelet-rich plasma versus steroid injection in plantar fasciitis: a randomized clinical trial

Sharma¹,

Chaudhary²,

Karki³

et al. 2023

BMC Musculoskelet Disord

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Background Plantar fasciitis (PF) is a common orthopaedic problem, with heel pain worsening the quality of life. Although steroid injection is often used if the conservative treatment fails, Platelet-Rich Plasma (PRP) injection is gaining popularity due to its safety and long-lasting effect. However, the effect of PRP versus steroid injection in PF has not been studied yet in Nepal. Therefore, this study aimed to assess the effect of PRP compared with steroid injection in the treatment of PF. Methods This study was a single-center, hospital-based, open-label, parallel-group randomized clinical trial to compare the effect of PRP injection with steroid injection in plantar fasciitis between August 2020 and March 2022. A total of 90 randomly selected participants aged 18 to 60 years suffering from plantar fasciitis with failed conservative treatment were intervened. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Visual Analog Scale (VAS) scoring system were used to evaluate functional mobility and pain before and after the intervention for three and six months, respectively. Statistical analyses were performed using a Student’s two-sample t-test. P-value < 0.05 was considered statistically significant. Results The PRP injection showed a better outcome than the steroid injection in six months follow-up. The mean (± SD) VAS score was significantly decreased in the PRP group (1.97 + 1.13) than in the steroid group (2.71 ± 0.94) with the group difference of -0.73 (95% CI: -1.18 to -0.28) at six months. Similarly, there was a significant increase in the AOFAS scores in the PRP group (86.04 ± 7.45) compared to the steroid group (81.23 ± 9.60) at six months of follow-up with a group difference of 4.80 (95% CI: 1.15 to 8.45). There was also a significant reduction of plantar fascia thickness in the PRP group compared to that of the steroid group (3.53 ± 0.81 versus 4.58 ± 1.02) at six months of follow-up with the group difference of -1.04 (95% CI: -1.44 to -0.65). Conclusion The PRP injection showed better outcomes than steroid injection in plantar fasciitis treatment over the course of six months. Further research with a larger population and longer follow-up than six months is needed to generalize the findings and their long-term efficacy. Trial registration NCT04985396. First registered on 02 August 2021. (https://clinicaltrials.gov/ct2/show/NCT04985396)

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“…38 According to the American Academy of Orthopedic Surgeons (AAOS), a single CS injection with a local anesthetic provides short-term pain relief as well as improved shoulder joint function. 39 A systematic review 40 reported that CS injections for the management of shoulder impingement yielded less pain at 6 weeks follow-up but not at T A B L E 5 Mean difference of functional and pain scores between corticosteroid and platelet-rich plasma treatment A previous meta-analysis 7 demonstrated that CS yielded shortterm pain relief as well as better functionality in comparison to PRP, which is in line with our findings, but the results were only reported as being statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…6 As a consequence, alternative treatment methods are being considered. 7 One of these is platelet-rich plasma (PRP).…”

Section: Introductionmentioning

confidence: 99%

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

Cited by 16 publications

References 55 publications

Assessment of Characteristics and Methodological Quality of the Top 50 Most Cited Articles on Platelet-Rich Plasma in Musculoskeletal Medicine

Assessment of Characteristics and Methodological Quality of the Top 50 Most Cited Articles on Platelet-Rich Plasma in Musculoskeletal Medicine

Effect of platelet-rich plasma versus steroid injection in plantar fasciitis: a randomized clinical trial

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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