Ultrasound guided injection of platelet enriched plasma versus corticosteroids in patients suffering rotator cuff tendinopathy

Abstract

Abstract Background Shoulder pain is the third most common musculoskeletal complaint. Rotator cuff tendinopathy is an overuse condition that manifests itself as pain in and around tendon and happens when the body fails to regenerate properly. This painful condition is associated with tendon disorganization and thickening that reduces its physical properties, which causes the tendon to fatigue, further exacerbating the painful condition with ultimate failure. A lot of trials and modalities of treatment are studied to avoid the surgical choice such as physiotherapy, NSAIDs and/or ESWT. Local injection of shoulder joint is widely used and studied but the diversity of results lead us to establish further studies. Objective The purpose of my study is to compare between two important modalities in non-surgical treatment of supraspinatus tendinopathy. Methods This study was conducted on 40 patients divided into two groups: group 1 received 3 subacromial injections of platelet rich plasma 10 days interval and group 2 received single subacromial injection of corticosteroid, both are ultrasound guided. Clinical examination using Constant Score is used to evaluate the patients before receiving treatment (0), one month (1) and six months (6) after receiving the treatment. Results We can conclude the results of the 2 groups as there is high significant improvement of the 2 groups comparing base line start. However Corticosteroids shows earlier improvement than PRP after 1 month follow up, but at the end of follow up (6 ms) PRP shows significant improvements according to Constant-Murley Score. According to group 1 there was no complications reported except a discomfort in shoulder region 24 hrs post injection up to 3 days maximum. While in group 2 there was no complications reported all through the 6 months follow up. Conclusion Ultrasound subacromial injection of corticosteroid and PRP achieved significant improvement in pain and function of shoulder joint in RCTs. Corticosteroid achieved better improvements according to Constant-Murley Score in short term follow up (4 weeks) than PRP group, while PRP achieved higher significant improvements than corticosteroid in pain and function of the joint after 6 months follow up as corticosteroid group showed decline in the pain and function results after 6 months follow up.