Limited evidence does not support the routine use of platelet rich plasma for the treatment of cuff tendinopathy or partial tears.

Management of Rotator Cuff Injuries
Endorsed by: AANA, ASES, AOSSM, ASSET, APTA
Limited Evidence LIMITED EVIDENCE
Rationale

Three high quality studies (Nejati 2017, Kesikburun 2013, Rha 2013) provided conflicting evidence regarding the role of platelet rich plasma (PRP) in cuff tendonopathy or partial tears.

One high quality study (Nejati 2017) compared PRP to exercise therapy for the treatment of subacromial impingement.  Both PRP and exercise therapy showed improvement  up to 6 months but exercise was more effective.

One high quality study (Kesikburun 2013) compared PRP to placebo (saline) injection therapy for the treatment of rotator cuff tendonopathy or partial tears for up to one year. Both treatments shows improvement in QoL, Function and pain scores but were equivalent at all time points.

One high quality study (Rha 2013) compared PRP to dry needling for up to 6 months. Functional scores of the platelet-rich plasma injection were superior to those of dry needling.

Despite the high quality of the above studies, the strength of the recommendation was downgraded to limited due to variability of study findings.

Risks and Harms of Implementing this Recommendation
There are no known risks to PRP injections that are specific to shoulders or the rotator cuff.

Future Research
Further research may be conducted to further define the role of PRP injections in rotator cuff pathology. Future studies should standardize the type of PRP formulation utilized or at the very least measure the concentrations of key constituents.

 

  1. Kesikburun, S, Tan, Ak, Yilmaz, B, Ya?ar, E, Yazicio?lu, K Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. The American journal of sports medicine 2013; 11: 2609-16
  2. Nejati, P., Ghahremaninia, A., Naderi, F., Gharibzadeh, S., Mazaherinezhad, A. Treatment of subacromial impingement syndrome: Platelet-rich plasma or exercise therapy?: A randomized controlled trial. Orthopaedic Journal of Sports Medicine 2017; 5:
  3. Rha, D. W., Park, G. Y., Kim, Y. K., Kim, M. T., Lee, S. C. Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial. Clinical Rehabilitation 2013; 2: 113-22