Comparative Efficacy of Platelet-Rich Plasma and Corticosteroid Injections for Rotator Cuff Injury Management: A Systematic Review and Meta-Analysis.

Abstract

Background: Rotator cuff injuries are very common in the athletic population and both corticosteroid injections and platelets enriched plasma (PRP) are common management options used in clinical practice yet there aren't any recent systematic reviews that compare between the two, thus, this study aims to provide a high-quality systematic review of the clinical trials and the experimentation found in the literature as of yet to guide practitioners in choosing between these two management options.

Methods: This systematic review was conducted in accordance to PRISMA guidelines and was registered in PROSPERO (CRD4202461663). A comprehensive search was done in the following databases MEDLINE, Web of Science, Google Scholar. The included studies were comparing Platelet Rich-Plasma with Corticosteroid injections for rotator cuff injuries for Adult patients that struggled with the injury for more than three months. The measurements that were used to determine the outcomes were: pain (VAS score) and functional scores (e.g Constant-Murley, ASES, SST).

Results: Pain reduction (VAS score) PRP showed to be somewhat better in the short term but had similar scores to corticosteroids on the remaining time marks, with the difference between them being insignificant, also, PRP showed to be more effective than Corticosteroids in improving function, particularly as time went on, the difference became more apparent (at 3-6 weeks, the mean difference was -3.97, after 24 weeks, it became 9.85 Constant-Murley).

Conclusion: When comparing between corticosteroids and PRP, there is no significant difference between them regarding pain reduction, yet, PRP has proven its effectiveness over the long-term for functional improvement, and which means that it could see more clinical use provided that it is cost-effective, yet more research is required to reach a final judgment and thorough evaluation due to the heterogeneity found in the studies.