Ultrasound-guided injection of platelet-rich plasma (PRP) in rotator cuff tendinopathy: effect on patients\u2019 symptoms and supraspinatus tendon thickness

Mohammed Sobhi Hassan,Dalia M. Elfawy,Gamal Eldine Niazi

doi:10.1186/s43055-020-00221-2

Abstract

BackgroundRotator cuff tendinopathy is considered a major cause of shoulder pain and disability that is increasing substantially with age affecting more than half of the general population by the age of 60 years. This study aims to assess the effect of ultrasound-guided injection of platelet-rich plasma on patient symptoms and supraspinatus tendon thickness in cases of rotator cuff tendinopathy.ResultsThis was a single-arm interventional study conducted on 30 patients with age ranging between 27 and 54 years old. Following US-guided injection of PRP, patients were evaluated clinically using the Shoulder Pain and Disability Index (SPADI) scoring system and radiologically using ultrasonographic supraspinatus tendon thickness measurements at 4, 8, 12, and 24 weeks. Our study showed remarkably noticeable changes when comparing the pre-injection and post-injection SPADI scoring system. There is highly statistically significant pain and disability score and percentage improvement, yet on the other hand, the radiological improvement shows no statistically significant difference found between baseline tendon thickness and its follow-up at 4, 8, and 12 weeks while only there was a statistically significant decrease in tendon thickness found at 24 weeks with P value = 0.043.ConclusionsThe ultrasound-guided PRP injection for supraspinatus tendinopathy cases is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising, and well-proved results when compared to other modality outcomes such as conventional surgeries, arthroscopic procedures, and physiotherapy.

Highlights

Rotator cuff tendinopathy has been considered a major cause of shoulder pain and disability that is increasing substantially with age affecting more than half of the general population by the age of 60 years [1]
This study aims to assess the effect of ultrasoundguided injection of platelet-rich plasma (PRP) on patient symptoms and supraspinatus tendon thickness in cases of rotator cuff tendinopathy
Inclusion criteria Patients complaining of shoulder pain with the following criteria: 1. Diagnosed with rotator cuff tendinopathy by musculoskeletal ultrasound

Summary

Introduction

Rotator cuff tendinopathy is considered a major cause of shoulder pain and disability that is increasing substantially with age affecting more than half of the general population by the age of 60 years. Rotator cuff tendinopathy has been considered a major cause of shoulder pain and disability that is increasing substantially with age affecting more than half of the general population by the age of 60 years [1]. Being responsible for 85% of the cases, rotator cuff tendinopathy is considered the most common cause of shoulder pain and disability [2]. Shoulder ultrasound plays a major role in the diagnosis of rotator cuff tendinopathy having the advantages of being readily available, highly sensitive, relatively inexpensive, and non-invasive. It has the disadvantages of being operator dependent and requiring standardized scanning technique [5]. The management of rotator cuff tendinopathy nowadays includes oral drugs (like NSAIDs), local injections with corticosteroids, and physical therapy or lastly

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