Shoulder injection of platelet-rich plasma versus corticosteroids in rotator cuff tendinopathies

Abstract

OBJECTIVE: To compare the efficacy of corticosteroid and platelet-rich plasma (PRP) injections on pain and function in chronic, non-ruptured rotator cuff tendinopathies. METHOD: In a 9 month prospective randomized trial, 52 patients were assigned to receive either corticosteroid (n = 26) or PRP (n = 26) injections. Pain was assessed using a visual analogue scale (VAS), and function was evaluated with shortened Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) and Shoulder Pain and Disability Index (SPADI) scores at baseline, 1 week, and 3 months. Adverse events were documented. RESULTS: The mean age was 62.3 ± 8.3 years, with 84.6% being female. Pain reduction was comparable between groups at 1 week (p = 0.49). At 3 months, corticosteroids achieved significantly greater pain relief (ΔVAS 3.35 vs 1.75; p = 0.02), confirmed by multivariate analysis (p = 0.01). Functional improvement was similar between groups; a non-significant trend favouring corticosteroids for QuickDASH was observed but not confirmed by multivariate analysis. Both treatments were well tolerated, with mild and transient adverse events: post-injection pain (PRP 73.1% vs CTC 53.8%) and local oedema (PRP 30.8% vs CTC 38.5%). CONCLUSION: Corticosteroids were more effective for pain reduction at 3 months, while PRP provided equivalent functional improvement. PRP may be an alternative for patients with corticosteroid contraindications. TRIAL REGISTRATION: Clinicaltrials.gov (NCT07094178).