Comparison of a Platelet-Rich Plasma Injection and a Conventional Steroid Injection for Pain Relief and Functional Improvement of Partial Supraspinatus Tears

Abstract

Background: Partial supraspinatus tendon tears have frequently been treated using a subacromial corticosteroid injection or surgery. The clinical use of a platelet-rich plasma (PRP) injection is an alternative treatment method for the condition, despite the paucity of evidence of its efficacy.

Purpose: To compare pain relief, functional improvement, and complications after an intratendinous PRP injection versus a subacromial corticosteroid injection for partial supraspinatus tears.

Study design: Randomized controlled trial; Level of evidence, 1.

Methods: A total of 32 patients with partial supraspinatus tears were randomly assigned to receive a leukocyte-poor PRP (LP-PRP) injection or a corticosteroid injection. One patient withdrew from the PRP group, leaving 15 patients in the PRP group and 16 patients in the corticosteroid group. The ultrasound-guided procedures were performed by a single experienced pain physician. Pain relief and functional improvement were evaluated using the visual analog scale (VAS) and the Oxford Shoulder Score (OSS), respectively. Treatment efficacy and complications were documented, and the 2 groups were compared at 1- and 6-month follow-up.

Results: There were no differences in VAS and OSS scores between the PRP and corticosteroid groups at 1-month follow-up. However, the PRP group had better scores than the corticosteroid group had on both the VAS and OSS at 6-month follow-up (VAS: 14.5 ± 15.4 vs 37.5 ± 24.9, respectively; OSS: 16.2 ± 3.9 vs 25.0 ± 10.2, respectively; P < .01 for both). Both groups showed significant improvement in VAS and OSS scores from before treatment to 1-month follow-up (mean difference, 35.67 and 11.47 points, respectively, for the PRP group; mean difference, 29.69 and 11.13 points, respectively, for the corticosteroid group; P < .01 for all). The VAS and OSS scores did not change significantly at 6-month follow-up in the corticosteroid group; however, the PRP group showed continued improvement in both VAS and OSS scores between 1- and 6-month follow-up (mean difference, 15.87 and 7.40 points, respectively; P < .01 for both). There were no complications in either group.

Conclusion: An injection using either a corticosteroid or LP-PRP resulted in a similar reduction in pain and improvement in function at 1 month in patients with a partial supraspinatus tear. However, PRP showed superior benefits over the corticosteroid at 6-month follow-up.

Keywords: pain intervention; platelet-rich plasma; rotator cuff tear; supraspinatus tear.

Figure 1.

Flow diagram of patient allocation process. OSS, Oxford Shoulder Score; PRP, platelet-rich plasma; VAS, visual analog scale.

Figure 2.

(A) Platelet-rich plasma (PRP) was injected into the supraspinatus tendon tear site. The blue arrow indicates a partial tear of the supraspinatus tendon; the red dot indicates the needle tip. (B) A corticosteroid was injected into the subacromial bursa. The blue arrows indicate partial tears of the supraspinatus tendon; the red dot indicates the needle tip.

Figure 3.

Visual analog scale (VAS) scores between the platelet-rich plasma (PRP) and corticosteroid groups before treatment, at 1-month follow-up, and at 6-month follow-up.

Figure 4.

Oxford Shoulder Score (OSS) results between the platelet-rich plasma (PRP) and corticosteroid groups before treatment, at 1-month follow-up, and at 6-month follow-up.