Platelet-rich plasma injection not beneficial for nonoperative treatment of rotator cuff disease

Reference

Hurley ET, Hannon CP, Pauzenberger L, Fat DL, Moran CJ, Mullett H. Nonoperative treatment of rotator cuff disease with platelet-rich plasma: A systematic review of randomized controlled trials. Arthroscopy 2019;35(5):1584-1591.

Synopsis

The benefits of PRP injections in the management of various tendinopathies are inconsistent. These investigators searched MEDLINE, Embase, and the Cochrane Library for English-language-only randomized controlled trials that compared PRP injections with control treatments in adults with chronic rotator cuff disease. Two reviewers used a standard evaluation tool to independently analyze individual articles for inclusion criteria and risk of bias. Discrepancies were resolved after consensus discussion with a third reviewer. Five studies (N = 214) met inclusion criteria, with 1 considered at low risk, 3 at moderate risk, and 1 at high risk of bias. Various controls included corticosteroid injection, dry needling, saline solution injection, and formal exercise therapy. At follow-up (range = 6 to 12 months), no differences occurred between active treatment with PRP injections and any of the control interventions for pain scores, disability measures, or range of motion. In the 2 studies in which PRP injections alone were used in the treatment group, the control group receiving exercise therapy had superior clinical outcomes.