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Published on: March 19, 2018
The efficacy of platelet-rich plasma compared to corticosteroids for partial-thickness rotator cuff tears: a
Mohammad Reza Guity1,2, Mahdi Sahebi1,2,3, Mohammad Pourfarzaneh1,2
1Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Management of partial-thickness rotator cuff tears (PTRCTs) remains debated, especially when conservative treatments fail. Corticosteroid (CS) and platelet-rich plasma (PRP) injections are frequently used, but their comparative effectiveness remains unclear. This study compares PRP and CS injections in improving shoulder range of motion, pain, and patient-reported outcomes in an Iranian population.
Methods:
A double-blind, randomized controlled trial was conducted with PTRCT patients receiving ultrasound-guided PRP or CS injections. Assessments included shoulder range of motion, visual analog scale for pain, Simple Shoulder Test, Constant-Murley Score, and Oxford Shoulder Score at baseline, 3 months, and 6 months postinjection.
Results:
Out of 208 patients screened, 107 were analyzed (39 PRP, 68 CS). Baseline measures were similar except for external rotation, which was higher in the PRP group (P < .05). The CS group showed significantly lower visual analog scale scores at 3 and 6 months (P < .001). No significant differences were found in forward flexion, abduction, or internal rotation (P > .05). External rotation remained greater in the PRP group throughout (P < .001). Simple Shoulder Test and Constant-Murley Scores were significantly higher, and Oxford Shoulder Score significantly lower, in the CS group at both follow-ups (P < .001). Both groups showed significant improvement from baseline, except for internal rotation in the PRP group at 6 months (P = .248).
Conclusion:
Both injections improve clinical outcomes in PTRCT, but CS injections provide superior short- and medium-term pain relief and patient-reported outcomes. CS is preferable for patients prioritizing rapid pain reduction. Further long-term studies are needed to assess sustained effects and safety.
