title: The effect of subacromial injections of autologous conditioned plasma versus cortisone for the treatment of symptomatic partial rotator cuff tears.
abstract: OBJECTIVE
  Rotator cuff tears are one of the most common causes of shoulder malfunction and pain, which lead to a significant reduction in the quality of life. This present study investigated the effects of subacromial platelet-rich plasma injections [i.e. autologous conditioned plasma (ACP) injections] as compared to standard subacromial cortisone injection therapy in 50 patients with partial rotator cuff tears.
  
  
  METHODS
  Before injection, and 6 weeks, 12 weeks and 6 months thereafter, the patients were assessed by the Constant-Murley score (CMS), the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), the simple shoulder test (SST) and a pain visual analogue scale (VAS). An MRI was also performed before and 6 months after injection.
  
  
  RESULTS
  Both patient groups had statistically significant better shoulder score outcomes over time. ASES, SST and CMS outcomes after 12 versus 6 weeks were better in the ACP group as compared to the cortisone group. VAS, ASES and CMS outcomes after 12 weeks versus baseline in the ACP group were better as compared to the cortisone group. There was a statistically significant difference between ACP group and cortisone group 12 weeks after injection regarding VAS, ASES, SST and CMS in favour of the ACP group. The MRI showed an improvement in grade of tendinopathy in both groups, however, without statistically significant differences between the two groups.
  
  
  CONCLUSIONS
  Compared with cortisone injections, ACP injections show earlier benefit as compared to cortisone injections although a statistically significant difference after 6 months could not be found. Therefore, subacromial ACP injections are a good alternative to subacromial cortisone injections, especially in patients with contraindication to cortisone.
  
  
  METHODS
  Therapeutic study, Level III.
authors.affiliation: Orthopädie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Lutz
authors.initials: L
authors.lastname: von Wehren
authors.affiliation: Klinik für Sportorthopädie und arthroskopische Chirurgie, Orthopädische Fachkliniken der Hessingstiftung, Hessingstrasse 17, 86199, Augsburg, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Blanke
authors.affiliation: Orthopädie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Atanas
authors.initials: A
authors.lastname: Todorov
authors.affiliation: Orthopädie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Heisterbach
authors.affiliation: Orthopädie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Jannis
authors.initials: J
authors.lastname: Sailer
authors.affiliation: Orthopädie, Universitätsspital Basel, Spitalstrasse 21, 4031, Basel, Switzerland. martin.majewski@usb.ch.
authors.forename: Martin
authors.initials: M
authors.lastname: Majewski
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001182:Arthroscopy; D016913:Blood Component Transfusion / Q000379:methods*; D003348:Cortisone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D053657:Platelet-Rich Plasma; D011788:Quality of Life; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries / Q000628:therapy*; D019534:Shoulder Impingement Syndrome / Q000628:therapy*; D052256:Tendinopathy / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D003348:Cortisone
keywords: Autologous conditioned plasma; Platelet-rich plasma; Rotator cuff; Shoulder pain; Subacromial impingement syndrome