Cortisone or platelet-rich plasma (PRP) injections for rotator cuff tendinopathy? Long term outcomes
Corticosteroids or platelet-rich plasma (PRP) injections for rotator cuff tendinopathy: a double blind is randomised clinical trial study May 2021
Shoulder pain and dysfunction is among the most common complaints with in medicine and disorders attributed to the rotator cuff being the most common cause of shoulder pains. The majority of shoulder pains are considered to be related to issues with the rotator cuff, more specifically tears within the supraspinatous muscle.
In the majority of cases of specific rehabilitation can be affective within the treatment of rotator cuff pathology, but time can be lengthy as the healing ability of tendons is limited, due to a poor blood supply. Thus, additional treatment modalities have been introduced that focus on the potential to promote and facilitate more rapid healing.
Conventionally, physical rehabilitation, rest, and nonsteroidal anti-inflammatory drugs (NSAIDs) are considered for a patient with shoulder pain related to rotator cuff issues as the first line of treatment. If the patient does not respond adequately to these, patients are offered a sub-acromial injection of corticosteroid, which have been shown to be affective in reducing inflammation. Corticosteroid (Cortisone) injection treatment has been shown to be more effective during the acute phase of tendinitis, although they have been associated with more long term risks of tendon tear and may inhibit collagen synthesis.
More recently, platelet-rich plasma (PRP) has been recognised and utilised for its unique biological role by in improving cellular healing process. Many studies have been conducted in recent years evaluating the role of both corticosteroid injections and PRP in the treatment of tendon inflammation, and many have reported more rapid benefits with PRP injections among patients, with better long-term outcomes. (See our previous posts).
Many of the previous studies have focused on pain and functional outcomes, here in this recent study they have focused on aims to evaluate the structural changes in the shoulders important rotator cuff muscles after cortisone injection in comparison to PRP injections in the settings of a double blind clinical trial study.
In this study, they compared the results of two of the most common treatment methods, PRP and cortisone injections, for shoulder related to rotator cuff pathology, within a double blind clinical trial study. It was identified that those who received PRP injections showed significant improvement in pain after three months of follow-up compared to the corticosteroid group. In regards to functional mobility, those who received PRP further showed better improvement during the follow-up period. In conclusion this study found that PRP renders similar results to that of corticosteroids in most clinical aspects among patients with RC tendinopathies; however, pain and functional mobility shows more significant improvement with the use of PRP. Considering that the use of corticosteroids may be contraindicated in some patients and may be associated with the risk of call long-term outcomes due to soft tissue damage and tendon rupture, it is further suggested that the use of PRP is favoured in place of corticosteroid based injections among patients with RC tendinopathy, particularly for improve long-term outcomes and for the use of the safer and more simple treatment.
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