Peritendinous leucocyte-poor platelet-rich plasma injections improve symptomatic chronic rotator cuff tendinopathies...

To assess the effect of a peritendinous leucocyte-poor platelet-rich plasma (PRP) injection protocol on patient-reported outcome measures (PROMs) in treating chronic rotator cuff tendinopathy (CRCT) or partial-thickness rotator cuff tears (PTT).

A single-centre retrospective case series of prospectively collected data was conducted. All patients diagnosed with CRCT or PTT undergoing peritendinous leucocyte-poor PRP injection were considered for eligibility. Inclusion criteria were: (1) active patients; (2) with proven CRCT or PTT of any rotator cuff tendon regardless of the aetiology and location on magnetic resonance imaging; (3) who had failed a conservative management programme; (4) with a complete data set from their scheduled follow-ups. Patient demographic data and written assessment visual analogue scale (VAS) for pain at rest, at night and on movement, single assessment numeric evaluation (SANE) and American Shoulder and Elbow Surgeons (ASES) scores, were collected at baseline and 6, 12 and 24 weeks, and annually post-injection.

A total of 47 patients, 22 males and 35 females, with a mean age of 49.6 ± 16.1 (range: 20-76), and a mean follow-up of 47 ± 17.4 months (range: 4-68.5) were included. No patient was lost at follow-up. Peritendinous leucocyte-poor PRP injection significantly improved VAS for pain (at rest, at night and on movement), SANE and ASES scores at the last follow-up (p < 0.001). Post-injection VAS for pain median was 0 at rest, at night and during movement. The SANE (mean 43.4 ± 16.3 to 92.2 ± 13.4) and ASES score (mean 39.7 ± 12 to 95.6 ± 9.09) improvement surpassed the minimum clinically important difference.

Ultrasound-guided peritendinous leucocyte-poor PRP injections may yield sustained medium-term improvements in PROMs in CRCT or PTT. These findings support the use of ultrasound-guided peritendinous leucocyte-poor PRP injections as an effective and durable non-surgical treatment option for managing CRCT and PTT.

Level IV.