Platelet-rich plasma injection for rotator cuff disease

Jeremy Loescher; Richard Guthmann; Beth Auten

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Table 1.

Summary of RCTs

RCT COMPARATORS	NO. OF PATIENTS	ASSESSED USING ...	FINAL FOLLOW-UP, MO	MEAN CLINICAL OUTCOME	SUPERIOR TREATMENT	RISK OF BIAS
PRP injection vs saline solution injection¹	40	SPADI, VAS, WORC Index	1	SPADI: 14.6 vs 15.4; P > .05 VAS: 0.8 vs 1.0;P > .05 WORC Index: 85.6 vs 79.7; P > .05	Equal	Low
PRP injection vs exercise therapy¹	42	DASH, VAS, WORC Index	6	DASH: 33.0 vs 26.2^* VAS: 4.5 vs. 4.2^* WORC Index: 58.7 vs 73.1^*	Exercise therapy	Moderate
PRP injection vs exercise therapy²	62	DASH, VAS	12	DASH: 35.6 vs 36.4; P = .79 VAS: 2.70 vs 2.59;P = .798	Equal	Moderate
PRP injection vs dry needling³	30	SPADI, VAS	6	SPADI: PRP injection from 62.3 to 17.7 vs dry needling from 62.8 to 29.5	PRP injection, but both were clinically effective	Moderate
PRP injection vscorticosteroidinjection¹	40	ASES, CMS, SST	6	ASES: 83.4 vs 78.9; P > .05 CMS: 90.5 vs 87.3; P > .05 SST: 10.2 vs 9.2;P > .05	Equal	High
PRP injection with surgery vs surgery without PRP injection⁴	781	ASES, CMS, UCLA Shoulder Scale, VAS	1.5 to 24	ASES: MD 1.22 (-0.65 to 3.09);P = .20 CMS: MD 2.65 (0.90 to 4.41)^† UCLA Shoulder Scale: MD 1.39 (0.61 to 2.17)^† VAS: MD -0.22 (-0.37 to -0.06)^†	PRP injection for 3 of the 4 measures	Moderate
PRP injection with surgery vs surgery without PRP injection⁵	1116	ASES, CMS, SST, UCLA Shoulder Scale, VAS	6.5 to > 12	ASES: WMD 0.74 (-0.77 to 2.24);P > .05 CMS: WMD 1.80 (0.63 to 2.96)^† SST: WMD 0.23 (-0.07 to 0.53) UCLA Shoulder Scale: WMD 0.97 (0.23 to 1.70) VAS: WMD -0.27 (-0.51 to -0.04)^*	Inconsistent and not clinically important	Moderate

ASES—American Shoulder and Elbow Surgeons; CMS—Constant-Murley Score; DASH—Disabilities of the Arm, Shoulder and Hand; MD—mean difference; PRP—platelet-rich plasma; RCT—randomized controlled trial; SPADI—Shoulder Pain and Disability Index; SST—Simple Shoulder Test; UCLA—University of California Los Angeles; VAS—visual analogue scale; WORC—Western Ontario Rotator Cuff; WMD—weighted mean difference.
↵* Statistically significant in favour of control.
↵† Statistically significant in favour of PRP injection.