Abstract
BackgroundSurgical treatment of full-thickness rotator cuff (RC) tears is associated with generally good results. There is no consensus regarding treatment of partial thickness tears that fail conservative treatment. The purpose of this study was to look at the efficacy and confirm the safety of dual injection PRP into the shoulder of patients with rotator cuff pathology who have failed conservative treatment with followup to two years.MethodsSeventy-one shoulders with MRI confirmed, rotator cuff pathology who failed conservative treatment, had dual PRP injection into the rotator cuff. Global improvement, Quick DASH and VAS scores were collected at 6, 12, and 24 months after treatment and comparison of means was used to analyze changes.ResultsNo adverse events were seen in any patient. Based on global rating scores positive results were seen in 77.9 % of patients at 6 months, 71.6 % at 1 year, and 68.8 % of patients at 2 years. Mean VAS scores improved from 50.2 [CI 44.4–56.0] pre-injection to 26.2 [CI 19.5–32.9] at 6 months, 22.4[CI 16.1–28.7] at 1 year and 18.2 [CI 12.3–24.1] at 2 years (p < 0.0001 for all). The mean Q- DASH scores (0-100, 100 worse) improved from 39.2 [CI 34.3–44.1] for all patients before treatment to 20.7[CI 15.0-26.4] at 6 months, 18.0[CI 12.9–23.1] at 1 year, and 13.8 [CI 8.4–18.8] at 2 years (p < 0.0001 for all). No patient with partial tear had clinical evidence of progression to full thickness tear. When separated into subgroups based on rotator cuff status, all subgroups showed improvement. Patients in the > 50 % partial tear group had the best overall improvement based on Global Rating scores while those in the tendinitis group had the poorest outcomes.ConclusionsPRP injection is a safe and effective treatment for RC cuff injury in patients who have failed conservative treatment of activity modification and physical therapy without deterioration of results two years after treatment. Better results are obtained with greater structural tendon damage than in shoulders with inflammation without structural damage.Trial registrationThis is not a clinical trial.
Highlights
Surgical treatment of full thickness rotator cuff (RC) tears is associated with generally good results [1]
Platelet rich plasma (PRP) has been used for treatment of RC tendinitis or partial thickness RC (PTRC) tears in a number of studies [12,13,14,15,16,17,18,19,20,21,22,23] and has shown improvement in symptoms compared to steroids [18, 19, 21, 22], physical therapy [13], hyaluronic acid [12], prolotherapy [17, 18], and placebo controls [12, 15]
All patients seen in this practice and diagnosed with rotator cuff pathology are initially placed on conservative treatment including activity modification and physical therapy
Summary
Surgical treatment of full thickness rotator cuff (RC) tears is associated with generally good results [1]. PRP has been used for treatment of RC tendinitis or partial thickness RC (PTRC) tears in a number of studies [12,13,14,15,16,17,18,19,20,21,22,23] and has shown improvement in symptoms compared to steroids [18, 19, 21, 22], physical therapy [13], hyaluronic acid [12], prolotherapy [17, 18], and placebo controls [12, 15]. The purpose of this study was to look at the efficacy and confirm the safety of dual injection PRP into the shoulder of patients with rotator cuff pathology who have failed conservative treatment with followup to two years
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
