Platelet-rich plasma for rotator cuff tendinopathy: A systematic review and meta-analysis

Mohamad Shariff A Hamid, Shariff Ghazali Sazlina, Mohamad Shariff A Hamid, Shariff Ghazali Sazlina

Abstract

Shoulder rotator cuff tendinopathy is a common debilitating condition that affects a person daily function and the quality of life. Despite its frequent occurrence, the best treatment is still inconclusive. This review assessed the clinical effect of platelet-rich plasma injection for rotator cuff tendinopathy. A systematic literature search was conducted using CINAHL, Medline, SCOPUS, SPORTSDiscus and Web of Science databases to retrieve articles published in peer-reviewed journals until December 2020. Randomised controlled trials (RCTs), which compared clinical effects of PRP injection to the usual care among adults diagnosed with rotator cuff conditions were reviewed. The main outcomes of interest were changes in shoulder pain symptoms and shoulder functions. All variables were analysed using random effects meta-analyses. Eight RCTs were reviewed in this study. The risk of bias for randomization was low for 6 RCTs, one study had unclear risk and the other was a high risk. Studies vary on the PRP techniques including preparation and injections. Moreover, the control intervention also differs. Four studies compared PRP with normal saline injection while in the remaining 4 RCTs the control intervention were rehabilitation program and dry needling. Meta-analysis of selected studies showed that PRP injection was safe and effective intervention for long-term pain control and shoulder function in patients with RC disorders.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flow diagram for selected studies.
Fig 1. Flow diagram for selected studies.
Fig 2. Quality assessment of selected studies.
Fig 2. Quality assessment of selected studies.
Fig 3. Forest plot on VAS shoulder…
Fig 3. Forest plot on VAS shoulder pain scores at 1, 3, 6, and 12 months follow-up.
Fig 4. Funnel plot on VAS pain…
Fig 4. Funnel plot on VAS pain scores at 1, 3, 6, and 12 months follow-up.
Fig 5. Forest plot on SPADI shoulder…
Fig 5. Forest plot on SPADI shoulder pain scores based on follow-up periods.
Fig 6. Forest plot on DASH functional…
Fig 6. Forest plot on DASH functional shoulder scores based on follow-up periods.

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