A Review of PRP for Rotator Cuff Injury
Recovery from tendon injuries is difficult because of the biologic properties of the tissue. Tendons are not highly vascularized, thus healing times can be prolonged compared to rates of healing in other tissues. The use of nutrient-dense PRP has emerged to address this issue. Hamid and Salina (2021) conducted a systematic review of the literature to determine if there is a consensus in the literature regarding clinical value for use of PRP in rotator cuff injuries. In this review, eight studies met inclusion criteria. All subjects in the studies met clinical and radiographic definitions of rotator cuff tear.
The Hamid review pooled data from eight studies. The difficulty with pooling various studies is that methodologies may vary across the studies. Although heterogeneity was adequate for inclusion, there was some variation across studies in PRP preparation technique and volume administered. Some studies administered 2 mLs, while others administered 4 mLs. Some injections were given weekly, and others monthly. The use of local anesthetics, which can dampen the response, varied as well.
Despite treatment variation across studies, six of eight trials showed significant improvement in pooled data at 12 months post-treatment. PRP injection(s) was significantly better for pain control at 6 months and 12 months. The current findings are consistent with a recent systematic review and meta-analysis, which concluded that PRP was significantly more effective in reducing pain up to six months. The Hamid meta-analysis revealed significantly better pain and function scores among patients treated with PRP than controls at all three follow-up time points: three weeks, three months, and six months.
PRP and prolotherapy were reported to be safe interventions with minimal adverse effects. This review showed a transient increase in pain of less than 3 days’ duration as the most frequent adverse effect reported among PRP-treated patients.
Reference
Hamid, A & Sazlina, SG. (2021) Platelet-rich plasma for rotator cuff tendinopathy: A systematic review and meta-analysis. PLoS ONE, 16(5): e0251111. https://doi.org/10.1371/journal.pone.0251111
