Editorial Commentary: Platelet-Rich Plasma Has Advantages Over Corticosteroid for Nonoperative Treatment of Rotator Cuff Pathology: Another Step in the Right Direction

Abstract

Lack of high-quality evidence has limited the widespread acceptance of platelet-rich plasma, bone marrow aspirate, and other therapeutics, collectively referred to as "orthobiologics," for partial-thickness rotator cuff tears and associated tendinopathies. The existing literature is limited, among other things, by underpowered studies and imprecise descriptions of the administration and/or formulation of the platelet-rich plasma being investigated. However, recent research favors platelet-rich plasma over corticosteroid injections in the nonoperative treatment of rotator cuff pathology. In light of evidence showing a deleterious effect of corticosteroids on subsequent surgical interventions, surgeons should continue to be wary of subacromial corticosteroid injections if alternatives such as platelet-rich plasma exist. A corticosteroid injection may have been the "go-to" nonoperative intervention in the past, but platelet-rich plasma may be a more effective arrow in our quiver. Of course, the conspicuous cost differential between these 2 different injections remains a very real consideration. However, this should be weighed against the increased risk (and cost) of a revision repair in the event that a surgical repair is performed subsequent to a corticosteroid injection.