Ultrasound-guided injection of platelet rich plasma versus corticosteroid for treatment of rotator cuff tendinopathy: Effect on shoulder pain, disability, range of motion and ultrasonographic findings

Abstract

Aim of the workTo compare the efficacy of ultrasound-guided platelet rich plasma (PRP) versus corticosteroid injection for treatment of rotator cuff tendinopathy (RCT). Patients and methodsThirty patients with RCT of the shoulder were randomly divided into 2 equal groups (15 each) treated by subacromial subdeltoid ultrasound-guided injection of PRP (group I) or corticosteroid (group II). Patients were evaluated using visual analogue scale (VAS) for pain, functionally assessed using the Shoulder Disability Questionnaire (SDQ) and range of motion (ROM) determined before and 8 weeks after injection. Ultrasonographic findings of the patients were also reported. ResultsPatients mean age was comparable between both groups (group I: 46.8 ± 10.6 and group II: 41.5 ± 12.5 years). The VAS at basline in group I (8.3 ± 1.1) and II (8.1 ± 1.2) significantly improved after injection (2.3 ± 1.4 and 2.3 ± 1.3; p = 0.0008 and p = 0.0009 respectively). The SDQ significantly improved in group I (90.3 ± 9.5 to 24.3 ± 5; p = 0.0009) and group II (89.3 ± 7.3 to 23.3 ± 6.2; p = 0.0007) after injection. There was a significant improvement in both groups after injection regarding the ROM (flexion, abduction, extension, internal and external rotation). There was a significant improvement in the frequency of tendinitis/bursitis in group II (66.6%) vs group I (50%) (p = 0.0008) while the improvement in the tear and effusion was higher in group I (66% and 60%) compared to group II (28.5% and 50%; p = 0.0005 and p = 0.001 respectively). ConclusionsBoth PRP and corticosteroid injections were effective in the treatment of RCT. PRP is a safe and good alternative to corticosteroid injection that promotes healing and decreases inflammation. Ultrasound-guided injection may increase the efficacy.