Efficacy of Ultrasound Guided Platelet-Rich Plasma in The Repair of Partial and Full-Thickness Supraspinatus Tears

Abstract

Background: Rotator cuff tears [RCT] are one of most common shoulder pain causes. Some patients do not give response to conservative treatments and patients couldn't get sufficient recovery after the surgery. Ultrasound guided platelet-rich plasma [PRP] administration may decreases the RCT sourced pains and improves functional abilities in patients with partial and complete rotator cuff tear. In this control group included study, the effectiveness of PRP treatment on RCT's has been revealed. Methods: In this randomized controlled clinical trial, the study included 90 patients who were randomized to four groups as: partial tear PRP, partial tear control, complete tear PRP and complete tear control. One cc PRP was obtained from 20 cc blood samples of patient, after double centrifuged at 400 g for 10 minutes. Under musculoskeletal ultrasound guidance, the PRP groups were given 3 injections of PRP in the affected shoulder at 3-week intervals. All groups were given a home exercise program 3 times per week. The range of motion, Quick DASH, Shoulder Pain and Disability Index [SPADI], Constant and VAS scores were used for the evaluation of patients at 3, 6 and 9 weeks, and 3, 6 and 12 months for follow-up visits. Results: In all groups, statistically significant improvements were observed in ROM, Quick DASH, SPADI, Constant and VAS scores [P < 0.05] at 12 months. Compared to control groups, more prominent improvements in all these clinical parameters were seen in PRP groups [P < 0.001]. It was also observed that the improvements seen after their first injection in PRP patients had persisted at 12 months. There was no significant difference in their improvements in these clinical parameters between PRP injected patients with partial RC tear and PRP injected patients with complete RC tear. Conclusion: We found significant and sustained improvement in pain and functional outcomes in PRP treated patients with RC tear. Our results suggest that PRP is the powerful treatment option in both patients with partial and complete RC tear and it may be an alternative approach before surgery in patients that do not benefit from conservative treatments.