Can platelet-rich plasma injections provide better pain relief and functional outcomes in persons with common shoulder diseases: a meta-analysis of randomized controlled trials

Abstract

Background: To evaluate the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of common shoulder diseases.Methods: The PubMed, Medline, and Central databases and trial registries were searched from their inception to July 2020 for randomized controlled trials of autologous PRP injections for shoulder diseases versus placebo or any control intervention. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed in the selection, analysis, and reporting of findings. The primary outcome was pain intensity (visual analog scale), and secondary outcomes were changes in function and quality of life (QoL). Results: A total of 17 randomized controlled trials of PRP versus control were analyzed. From 8–12 weeks to ≥1 year, PRP injections were associated with better pain relief and functional outcomes than control interventions. PRP injections were also associated with greater QoL, with an effect size of 2.61 (95% confidence interval, 2.01–14.17) at medium-term follow-up. Compared with placebo and corticosteroid injections, PRP injections provide better pain relief and functional improvement. In subgroup analyses, trials in which PRP was prepared by the double centrifugation technique, the platelet concentration in the PRP was enriched ≥5 times, leucocyte-rich PRP was used, or an activating agent was used before application reported the most effective pain relief at 6–7 months. Conclusions: PRP injections could provide better pain relief and functional outcomes than other treatments for persons presenting with common shoulder diseases. PRP injections have a greater capacity to improve shoulder-related QoL than other interventions.

Recent Nonoperative Treatment of Elbow Pain

“…A study focusing on tendinopathy cases found that both PRP and corticosteroid injections led to improvements in patient symptoms. The study concluded that PRP could serve as a safe and effective alternative to corticosteroids, even over extended periods, to lessen both local and systemic effects associated with corticosteroid injections [32,33]. This treatment strategy could be especially advantageous for patients with diabetes, as PRP injections have been shown to be well-tolerated and safe [34].…”

Osteoarthritis: Insights into Diagnosis, Pathophysiology, Therapeutic Avenues, and the Potential of Natural Extracts

“…Therefore, integrating pharmacological interventions such as nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics becomes essential [132][133][134]. Additionally, personalized treatment plans, overseen by medical specialists, may incorporate intra-articular therapies like steroids, platelet-rich plasma (PRP), and hyaluronates to augment symptom management [135][136][137].…”

Differential Diagnosis of Elbow Pain

“…If epicondylitis remains unimproved after 3 to 6 months of treatment, it is considered refractory and surgical intervention may be indicated. Conservative treatment encompasses exercise therapy, physical therapy, drug therapy, bracing, extracorporeal shock wave therapy, percutaneous pie crusting of the tendon origin [9] polydeoxyribonucleotide injections [10], platelet-rich plasma (PRP) injections [11], autologous blood injections [12], and local corticosteroid injection therapy.…”