Platelet-Rich Plasma Injection in Non-Operative Treatment of Partial-Thickness Rotator Cuff Tears: A Systematic Review and Meta-Analysis.

Abstract

ObjectivePartial-thickness rotator cuff tears have a high prevalence in older people. Treatment for such tears remains controversial. Platelet-rich plasma has recently attracted attention for treating partial-thickness rotator cuff tears, due to its regenerative characteristics. However, the results of application of platelet-rich plasma in non-operative treatments are unclear. The aim of this review is to evaluate the effects on shoulder function improvement and pain relief of platelet-rich plasma injection in partial-thickness rotator cuff tears, at different follow-up times (3–6 weeks, 8–12 weeks, and more than 24 weeks after treatment) compared with placebo or corticosteroids.DesignA systematic review and meta-analysis.MethodsSeveral databases, including PubMed, EMBASE, and Cochrane, were searched. Eleven studies met the inclusion criteria for the meta-analysis. The quality of research was evaluated using the Cochrane risk-of-bias tool. The effectiveness of platelet-rich plasma was calculated as the difference between baseline measurements and post-injection outcomes. The standardized mean difference was used to compare different outcome scales or questionnaire measurements. Statistical analysis was performed using Stata 15.0.ResultsThe analysis included 11 studies, with a total of 641 patients (318 treated with platelet-rich plasma and 323 controls). Compared with placebo, platelet-rich plasma exhibited significantly better effects on shoulder function improvement and pain relief at all 3 follow-up times. Compared with other conservative treatments, platelet-rich plasma exhibited significantly better effects on shoulder function and pain relief at 8–12 weeks and at more than 24 weeks after treatment.ConclusionThis review showed positive effects on shoulder function improvement and pain relief of the use of platelet-rich plasma in treating partial-thickness rotator cuff tears, especially in relatively late stages of follow-up (more than 8 weeks) after treatment.LAY ABSTRACTPartial-thickness rotator cuff tears are common, especially in older people, and can cause shoulder pain and movement limitation. Platelet-rich plasma is a platelet concentrate made from autologous blood, which may have anti-inflammatory and healing effects. This systematic review and meta-analysis collected data from existing studies to determine the specific effects of platelet-rich plasma injection on partial-thickness rotator cuff tears. The results showed that, compared with both no treatment and other conservative treatments, platelet-rich plasma reduced pain and improved shoulder function when used to treat partial-thickness rotator cuff tears. Meanwhile, the effects were most significant at 8–12 weeks and at more than 24 weeks after treatment.