Platelet-Rich Plasma and Corticosteroid in the Treatment of Rotator Cuff Impingement Syndrome: Randomized Clinical Trial

Abstract

Objective This research aims to study the effectiveness of platelet-rich plasma (PRP) in the treatment of patients with rotator cuff impingement syndrome compared with the treatment with subacromial injection of corticosteroids. Methods This is a double-blind, randomized, comparative clinical trial. The patients were clinically evaluated with the use of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure, University of California Los Angeles (UCLA) shoulder rating scale and Constant-Murley shoulder outcome score (CMS) on the day of application, and then again after 1, 3 and 6 months. Results No statistically significant differences were found ( p < 0.05) when comparing the results of the DASH outcome measure, UCLA shoulder rating scale and CMS of the two groups at baseline and after 1, 3, and 6 months of treatment with subacromial injection. After the treatment, both groups showed a significant improvement in the DASH and UCLA scores ( p < 0.05) when compared with the baseline. However, the CMS at 6 months after treatment with steroids was lower than the baseline. Concusions These findings suggest that PRP is a safe treatment and can be a useful tool in the therapeutic arsenal against of the rotator cuff diseases, for there was no significant difference between the subacromial use of PRP and corticosteroids.

Keywords: adrenal cortex hormones; platelet-rich plasma; shoulder impingement syndrome.

Conflict of interest statement

Conflitos de Interesse Os autores declaram não haver conflitos de interesse.

Figures

Fig. 1

Evolution of the Disabilities of the Arm, Shoulder and Hand (DASH) score of patients with rotator cuff tendinopathy after 1, 3, and 6 months of treatment with corticosteroids and platelet-rich plasma. (p-value shown represents statistical difference from that of admission). Abbreviations: DASH, Disabilities of the Arm, Shoulder and Hand; PRP, platelet-rich plasma.

Fig. 2

Evolution of the University of California Los Angeles UCLA shoulder rating scale of patients with rotator cuff tendinopathy after 1, 3, and 6 months of corticosteroids and platelet-rich plasma treatment. (p-value shown represents statistical difference from that of admission). Abbreviations: UCLA, University of California Los Angeles; PRP, platelet-rich plasma.

Fig. 3

Evolution of the Constant-Murley shoulder outcome score (CMS)of patients with rotator cuff tendinopathy after 1, 3, and 6 months of corticosteroids and platelet-rich plasma treatment. (p-value shown represents statistical difference from that of admission). Abbreviation: PRP, platelet-rich plasma.

Fig. 1

Evolução da pontuação da medida de desfechoDisabilities of the Arm, Shoulder and Hand(DASH) em pacientes com tendinopatia do manguito rotador após 1, 3, e 6 meses de tratamento com corticosteroides e plasma rico em plaquetas (PRP). (O valor depmostrado representa a diferença estatística em comparação ao valor obtido à admissão).

Fig. 2

Evolução da escala de classificação do ombro UCLA em pacientes com tendinopatia do manguito rotador após 1, 3, e 6 meses de tratamento com corticosteroides e plasma rico em plaquetas (PRP). (O valor depmostrado representa a diferença estatística em comparação ao valor obtido à admissão).

Fig. 3

Evolução do escore do ombro de Constant-Murley em pacientes com tendinopatia do manguito rotador após 1, 3, e 6 meses de tratamento com corticosteroides e plasma rico em plaquetas (PRP). (O valor depmostrado representa a diferença estatística em comparação ao valor obtido à admissão).