The Efficacy of Injections for Partial Rotator Cuff Tears: A Systematic Review

Abstract

(1) Background: Even though rotator cuff tears are the most frequent tendon injuries in adults, the effectiveness of conservatively treated partial-thickness tears still remains a matter of debate. The purpose of this review is to compare corticosteroid injections to other drugs in the treatment of partial rotator cuff tears, focusing on the effectiveness of this therapeutic modality in terms of pain and shoulder functionality. (2) Methods: A systematic electronic search was performed using the PubMed (MEDLINE), EMBASE and Cochrane Library databases. All studies comparing the use of corticosteroids and other infiltrative techniques in the treatment of partial lesions (excluding studies that considered subacromial impingement as inclusion criteria) were pooled, data were extracted and statistically analyzed. (3) Results: Nine studies were included in this systematic review. Those studies, composed by a total of 494 shoulders treated, have been published from 1985 to 2019. All compared techniques have shown a significant improvement over baseline condition. PRP (Platelet Rich Plasma) injections have been shown to be significantly more effective in both functional and pain control only in the long term. (4) Conclusions: None of the techniques prevail indisputably on the others. Anyway, the treatment of partial rotator cuff tears with PRP injections seems to lead to significantly better outcomes in terms of pain and shoulder function in long term follow up. Whereas in short and medium term follow up, PRP injections was superior only in terms of shoulder function. The small number of studies on prolotherapy did not enable us to provide an opinion on the outcomes of this technique.

Interest of platelet rich plasma in Achilles tendon rupture management: a systematic review

“…Therefore, it has a major impact on athletes and there is a need for an accelerated and performant healing strategy. PRP is gaining increasing attention as an adjuvant for tendon healing and its safety has been established [10,12,[14][15][16]24,29,39]. It is emerging for its use in ATR and in other pathologies such as epicondylitis and rotator cuff injuries [12,14,[29][30][31]40].…”

“…Therefore, its interest has been suggested in the management of bone, cartilage, tendon and muscle injuries [13]. Recent studies have enhanced the interest of PRP in tendon and ligament pathologies, especially in partial rotator cuff tear [14]. However, no benefit has been clearly shown in chronic Achilles tendinopathy [15].…”

Behandlung von Sehnenrupturen mit Stammzellen: eine aktuelle Übersicht

“…Die jüngsten Metaanalysen zur Behandlung von Teilrupturen der Rotatorenmanschette mit Injektionen von PRP deuten ebenfalls darauf hin, dass der trophische Support zur vollständigen Regeneration der Sehne wohl nicht ausreichend ist [15,39]. Für die Behandlung von Teilrupturen der Rotatorenmanschette mit Exosomen und Amnionflüssigkeit liegen in der Literatur bisher keine Studien vor.…”

Effectiveness of subacromial injections in rotator cuff lesions: systematic review and meta-analysis protocol

“…However, the current evidence for these therapies remains controversial both in terms of effectiveness and dosage; no clear consensus can be found regarding the frequency of injections for partial rotator cuff tears or the most effective therapy for these lesions in the short, medium and long term. 19 The latest systematic review and meta-analysis on the subject was published in 2019, with a deadline for data collection in September 2017, quasi-randomised clinical trials were excluded and the LILACS search platform was not included. 20 Since then, several randomised clinical trials have been published, and there is a need for a subject update to guide clinical practice concerning intervention that is the most effective treatment for RCIs.…”