Subacromial Platelet-Rich Plasma Injections Produce Significantly Worse Improvement in Functional Outcomes in Patients With Partial Supraspinatus Tears Than in Patients With Isolated Tendinopathy

Abstract

The purpose of this study was to compare the effect of subacromial leukocyte-rich PRP injections in patients with isolated rotator cuff tendinopathy (RCT) and those with partial thickness rotator cuff tears (PTRCTs) based on functional outcomes, pain improvement, sleep disturbances, and return to sports. Between November 2019 and March 2021, 150 patients underwent PRP injections at our institution for refractory rotator cuff tendinopathy and partial rotator cuff tears (105 RCTs and 45 PTRCTs). The American Shoulder and Elbow Surgeons (ASES) score, the visual analog scale (VAS) for pain, the Single Assessment Numeric Evaluation (SANE) and The Pittsburgh Sleep Quality Index were evaluated at 2, 6 and 12 month follow up. Return to sports was also evaluated. An ultrasound examination was performed to evaluate structural outcomes 12 months after the injection. The mean age was 36.6 years (±9.08). Overall, the ASES, VAS, SANE and Pittsburgh scores showed statistical improvement after the injection (P < .01). Specifically, the improvement in the ASES score which was the primary outcome measure was significantly greater in the group without tears than in the group with PTRCTs at all follow-up times. Moreover, 94% of the patients in the isolated RCT group and 49% in the PTRCTs group achieved a substantial clinical benefit at 12 months follow up. Ten out of the 50 patients (20%) who received PRP injections due to a partial RC tear underwent surgery due to lack of clinical improvement. Subacromial PRP injections produced a significant improvement in shoulder function, pain and sleep disturbances in most patients with RCT refractory to conservative treatment that was maintained up to 12-month follow-up. Moreover, most patients returned to sports at the same level they had previous to the injury. However, improvement in symptoms and functional outcomes were significantly worse in patients who had a PTRCT compared with patients who had an isolated tendinopathy.