Platelet Rich Plasma (PRP) and Partial Rotator Cuff Tears

Partial tears of the rotator cuff are common, especially among active adults and athletes, and often present with pain, reduced range of motion, and impaired shoulder function. Traditional treatments include physical therapy, corticosteroid injections, and in severe cases, surgical intervention. However, emerging biologic therapies, particularly platelet-rich plasma (PRP), have shown promise in enhancing tissue healing and providing an alternative treatment pathway.

Understanding PRP and its Mechanism of Action

PRP is derived from the patient’s blood and consists of a high concentration of platelets, which are rich in growth factors and cytokines. These factors, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β), are known to play a key role in tissue repair by promoting cellular proliferation, tissue remodeling, and collagen synthesis. When injected into an area with tissue damage, such as a partially torn rotator cuff, PRP aims to enhance the body’s natural healing response.

Evidence for PRP in Partial Rotator Cuff Tears

The efficacy of PRP in managing rotator cuff injuries has been studied extensively, but results are mixed. Several landmark studies provide insights into the role of PRP in the management of partial rotator cuff tears:

Kesikburun et al. (2013) conducted a randomized controlled trial that evaluated the effects of PRP on partial rotator cuff tears, finding that PRP injections resulted in statistically significant improvements in pain and shoulder function at six-month follow-up compared to control patients receiving saline injections. This study highlighted PRP’s potential to improve clinical outcomes in the short term for partial tears, although long-term benefits remained uncertainha et al. (2013)** compared the effects of PRP versus dry needling in patients with partial rotator cuff tears. Patients receiving PRP demonstrated superior functional outcomes and pain relief at six weeks and three months post-treatment. This study emphasized the potential benefits of PRP over traditional needling techniques, suggesting that PRP may provide more substantial tissue healing through its biologic properties .

Rodeo et al (2016) explored PRP’s biological effects on tendon healing through laboratory and clinical models. Their findings indicate that PRP’s growth factors aid in collagen production and angiogenesis, essential for tendon repair. While they acknowledged variability in PRP formulations and protocols, their work contributed to a deeper understanding of the mechanisms that make PRP a promising adjunctive treatment for rotator cuff injuries .

References:

1. Kesikburun S, et al. "Platelet-Rich Plasma Injections in the Treatment of Chronic Rotator Cuff Tendinopathy: A Randomized Controlled Trial." Am J Sports Med. 2013.

2. Rha DW, et al. "Comparison of the Therapeutic Effects of Ultrasound-Guided Platelet-Rich Plasma Injection and Dry Needling in Rotator Cuff Disease: A Randomized Controlled Trial." Clin Rehabil. 2013.

3. Rodeo SA, et al. "Biologic Augmentation of Rotator Cuff Tendon Healing." Clin Sports Med. 2016.

4. Saltzman BM, et al. "Does the Use of Platelet-Rich Plasma at the Time of Surgery Improve Clinical Outcomes in Patients Undergoing Rotator Cuff Repair? A Systematic Review and Meta-Analysis of Randomized Controlled Trials." Arthroscopy. 2020.