Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears

Shams, Ahmed; El-Sayed, Mohamed; Gamal, Osama; Ewes, Waled

doi:10.1007/s00590-016-1826-3

Cited by 136 publications

(140 citation statements)

References 39 publications

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“…One large difference in methodology is that the majority of those enrolled in one-time single-site injections were compared to active interventions of enthesis saline, which has demonstrated some efficacy in the study of Bertrand et al, and subacromial corticosteroid injection, which has previously demonstrated efficacy in rotator cuff tendinopathy. 11,[24][25][26] Another methodologic difference is that patients included in one-time single-site injection studies tended to have milder baseline pain with lower pain intensity scores and improved baseline function with low SPADI scores and more active range of motion. Despite these methodologic differences, repeat multisite dextrose prolotherapy protocols demonstrated larger absolute improvements in VAS, SPADI, and range of motion.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Catapano

Zhang

Mittal

et al. 2019

PM&R

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Objective To systematically review and evaluate the efficacy and complication profile of prolotherapy using hyperosmolar dextrose solution injection for rotator cuff tendinopathy. Literature Survey MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (from inception to 1 July, 2019). Methodology A comprehensive search was completed to identify randomized controlled trials addressing prolotherapy using hyperosmolar dextrose solution for rotator cuff tendinopathy. Two reviewers independently screened the titles, abstracts, and full texts, and then extracted data from eligible studies. All reported outcome measures and complications were analyzed descriptively. Synthesis Five studies satisfied inclusion criteria. Included studies analyzed a total of 272 participants with a final follow‐up ranging from 6 weeks to 12 months. Prolotherapy differed greatly among studies. Two studies used a multisite enthesis injection protocol while the other three used ultrasound‐guided protocols. Two of the studies used an intrasubstance supraspinatus injection and three used a supraspinatus enthesis injection. Control groups consisted of nonoperative rehabilitation including physical therapy and medical management in three studies, supraspinatus saline enthesis injection in one study, and corticosteroid injection in one study. There was statistically significant improvement in pain intensity with multisite injection protocols compared to physical therapy and medical management in both studies. Ultrasound‐guided supraspinatus injection trials did not find any statistically significant difference in pain intensity, range of motion, strength, function, or ultrasound characteristics compared to controls of enthesis saline injection or corticosteroid. The complication rate was low, with only 6/272 participants experiencing adverse events consisting of transient increase in pain for 1 to 2 days postintervention. Conclusions Prolotherapy with hyperosmolar dextrose solution is a potentially effective adjuvant intervention to physical therapy for patients with rotator cuff tendinopathy ranging from tendinosis to partial‐thickness and small full‐thickness tears. Further studies are necessary to determine effects in subpopulations as well as optimal technique including dextrose concentration, volume, and location.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Catapano

Zhang

Mittal

et al. 2019

PM&R

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“…Rha et al 24 have applied PRP twice and demonstrated that the activity continued even at month six; however, their sample size was smaller. On the other hand, Shams et al 26 have administered a single dose of PRP; however, in month six, they detected that PRP activity did not continue. Furthermore, Randelli et al 25 have shown that PRP treatment was effective during arthroscopic repair in patients with full-thickness tears, while no long-term efficacy was detected.…”

Section: Discussionmentioning

confidence: 98%

Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome

et al. 2019

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Objectives: This study aims to investigate and compare the efficacy of platelet-rich plasma (PRP) injection, corticosteroid injection, and physical therapy in addition to exercise treatment on pain, shoulder functions, and quality of life in patients with subacromial impingement syndrome (SAIS). Patients and methods: Ninety patients (37 males, 53 females; mean age 48.99 years; range, 33 to 60 years) who were diagnosed as Stage 2 SAIS were included in the study. Patients were randomized into three groups. PRP injection was administered into the subacromial space of the affected shoulder in group 1, corticosteroid injection was administered in the subacromial joint space in group 2, and 10 sessions of physical therapy were given in group 3 five times weekly including transcutaneous electrical nerve stimulation, ultrasound, and hot packs. Moreover, an exercise program was administered in all groups. visual analog scale (VAS) was used to determine the resting and moving shoulder pain; while the Shoulder Disability Questionnaire, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and the University of California, Los Angeles Shoulder Rating Scale (UCLA SRS) were used to evaluate the functionality of patients. Quality of life was analyzed using a generic Short Form 36 (SF-36). Results: All scores improved in all three groups compared with the period before treatment. Comparison of the groups showed higher scores in group 1 compared to groups 2 and 3 at week eight on QuickDASH, UCLA SRS, VAS at rest and during activity, and SF-36 pain subgroup scores. Conclusion: All three treatment modalities were effective in the treatment of SAIS. However, we suggest that the inexpensive and noninvasive methods of physical therapy and exercise should be the first preferred treatment in SAIS owing to causing no adverse events.

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“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] The most common reasons for exclusion were review paper (53), non-tendinopathy (14), injection of active control (7; eg, whole blood, PRP) and non-randomised study (7). Several manuscripts were excluded from this review because they were superseded by papers from the same study with longer follow-up including de Vos et al 29 30 and Peerbooms et al 31 A flow diagram of study identification and selection is shown in figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: systematic review and meta-analysis of randomised injection-controlled trials

Miller

Parrish²,

Roides³

et al. 2017

BMJ Open Sport Exerc Med

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AimTo determine the efficacy of platelet-rich plasma (PRP) injections for symptomatic tendinopathy.DesignSystematic review of randomised, injection-controlled trials with meta-analysis.Data sourcesSystematic searches of MEDLINE and EMBASE, supplemented by manual searches.Eligibility criteria for selecting studiesRandomised controlled trials with 3 months minimum follow-up that evaluated pain reduction with PRP versus control (saline, local anaesthetic, corticosteroid) injections in patients with symptomatic tendinopathy.ResultsA total of 16 randomised controlled trials (18 groups) of PRP versus control were included. Median sample size was 35 patients, a study size that would require an effect size ≥1.0 to achieve statistical significance. PRP was more efficacious than control in reducing tendinopathy pain, with an effect size of 0.47 (95% CI 0.22 to 0.72, p<0.001), signifying a moderate treatment effect. Heterogeneity among studies was moderate (I2=67%, p<0.001). In subgroup analysis and meta-regression, studies with a higher proportion of female patients were associated with greater treatment benefits with PRP.ConclusionsInjection of PRP is more efficacious than control injections in patients with symptomatic tendinopathy.

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Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears

Abstract: II.

Cited by 136 publications

References 39 publications

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review

Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome

Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: systematic review and meta-analysis of randomised injection-controlled trials

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