Introduction
Rotator cuff tears are common causes of shoulder pain and disability. Some tears that are initially silent may progress to become symptomatic. Surgery is a traditional option, and while it does improve pain and function, there are surgical risks, including infection, delayed healing, shoulder stiffness, and injury to other tendons.
The Study
Gharbawy and Labib (2020) conducted a prospective study involving thirty patients with ultrasound-documented partial rotator cuff tears to determine the effectiveness of platelet-rich plasma (PRP) on healing. PRP was prepared using a double centrifugation technique, and a single treatment of 5 mL of PRP was injected under ultrasound guidance into the partial tear of the tendon or the tissue around it. Two days after the injection, an exercise program was started. The exercises were initially passive and progressed to include isotonic strengthening and stretching.
At baseline, the severity of the patients’ tears was graded by ultrasound. Four patients (13%) had a grade 2 tear (0 = normal, 4 = severe), eighteen (60%) had a grade 3, and eight (26%) had a grade 4. These scores changed significantly after the PRP treatment. Post-treatment, approximately 53% of patients scored a grade of 1, approximately 40% received a grade of 2, and approximately 8% received a score of 3.
Results
At baseline, the mean pain score was 7.1 on a 10-point visual analog scale. After treatment, the mean pain score dropped to 3.7, representing a 47.9% improvement. Disability scores improved by 46.5% following the PRP injection. The improvement in pain and function, along with improved ultrasound grading, suggests healing at the tissue level. Recovery was rapid, which is important because tissue healing potentially reduces the risk of re-injury.
Conclusion
PRP is superior to physical therapy alone. It offers a safe and minimally invasive alternative to surgery with a reduced risk of adverse effects.
Reference
Gharbawy, N. H., & Labib, H. S. (2020). Role of platelet-rich plasma (PRP) injection in the treatment of rotator cuff tear. Egyptian Rheumatology and Rehab, 47, 30.
