部分層回旋腱板損傷に対する血小板豊富血漿とステロイドの有効性の比較：ランダム化比較試験
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.
