Efficacy of platelet-rich plasma for the treatment of interstitial supraspinatus tears: a double-blinded, randomized controlled trial
AJ Schwitzguebel, FC Kolo, J Tirefort… - … American journal of …, 2019 - journals.sagepub.com
AJ Schwitzguebel, FC Kolo, J Tirefort, A Kourhani, A Nowak, V Gremeaux, M Saffarini…
The American journal of sports medicine, 2019•journals.sagepub.comBackground: The benefits of platelet-rich plasma (PRP) for the treatment of rotator cuff tears
remain inconclusive, as it is administered either as an adjuvant to surgical repair or as a
primary infiltration without targeting the index lesion, which could dilute its effect. Purpose:
To determine whether PRP infiltrations are superior to saline solution infiltrations (placebo)
at improving healing, pain, and function when injected under ultrasound guidance within
isolated interstitial supraspinatus tears. Study Design: Randomized controlled trial; Level of …
remain inconclusive, as it is administered either as an adjuvant to surgical repair or as a
primary infiltration without targeting the index lesion, which could dilute its effect. Purpose:
To determine whether PRP infiltrations are superior to saline solution infiltrations (placebo)
at improving healing, pain, and function when injected under ultrasound guidance within
isolated interstitial supraspinatus tears. Study Design: Randomized controlled trial; Level of …
Background
The benefits of platelet-rich plasma (PRP) for the treatment of rotator cuff tears remain inconclusive, as it is administered either as an adjuvant to surgical repair or as a primary infiltration without targeting the index lesion, which could dilute its effect.
Purpose
To determine whether PRP infiltrations are superior to saline solution infiltrations (placebo) at improving healing, pain, and function when injected under ultrasound guidance within isolated interstitial supraspinatus tears.
Study Design
Randomized controlled trial; Level of evidence, 1.
Methods
In this single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic isolated interstitial tears of the supraspinatus, confirmed by magnetic resonance arthrography, were randomized to PRP or saline injections. Each patient received 2 injections with a 1-month interval. The primary outcome was the change in lesion volume, calculated on magnetic resonance arthrography, at 7 months. The secondary outcomes were improvements in shoulder pain and the Single Assessment Numerical Evaluation (SANE) score at >12 months.
Results
Preoperative patient characteristics did not differ between the 2 groups. At 7 months, there were no significant differences between the PRP and control groups in terms of a decrease in lesion size (–0.3 ± 23.6 mm3 vs –8.1 ± 84.7 mm3, respectively; P = .175); reduction of pain on a visual analog scale (VAS) (–2.3 ± 3.0 vs –2.0 ± 3.0, respectively; P = .586); and improvement in SANE (16.7 ± 20.0 vs 14.9 ± 29.0, respectively; P = .650), Constant (8.6 ± 13.0 vs 10.7 ± 19.0, respectively; P = .596), and American Shoulder and Elbow Surgeons (19.5 ± 20.0 vs 21.9 ± 28.0, respectively; P = .665) scores. At >12 months, there were no significant differences between the PRP and control groups in terms of a reduction of pain on a VAS (–3.3 ± 2.6 vs –2.3 ± 3.2, respectively; P = .087) or improvement in the SANE score (24.4 ± 27.5 vs 23.4 ± 24.9, respectively; P = .846). At 19.5 ± 5.3 months, the incidence of adverse effects (pain >48 hours, frozen shoulder, extension of lesion) was significantly higher in the PRP group than the control group (54% vs 26%, respectively; P = .020).
Conclusion
PRP injections within interstitial supraspinatus tears did not improve tendon healing or clinical scores compared with saline injections and were associated with more adverse events.
Registration
NCT02672085 (ClinicalTrials.gov identifier).
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