title: Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears.
abstract: OBJECTIVE
  Rotator cuff tears are one of the most common causes of chronic shoulder pain and disability. They significantly affect the quality of life. Reduced pain and improved function are the goals of conventional therapy, which includes relative rest, pain therapy, physical therapy, corticosteroid injections and surgical intervention. Tendons have a relative avascular nature; hence, their regenerative potential is limited. There is some clinical evidence that the application of autologous platelets may help to revascularize the area of injury in rotator cuff pathologies.
  
  
  METHODS
  This prospective randomized controlled study was done to evaluate the results of subacromial injection of platelet-rich plasma (PRP) versus corticosteroid injection therapy in 40 patients with symptomatic partial rotator cuff tears. All patients were assessed before injection, 6 weeks, 3 and 6 months after injection, using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), the Constant-Murley Score (CMS), the Simple Shoulder Test (SST) and a Visual Analog Scale (VAS) for pain. An MRI was performed before and 6 months after the injection for all the included patients and was graded on 0-5 scale.
  
  
  RESULTS
  Both injection groups showed statistically significantly better clinical outcomes over time compared with those before injection. There was a statistically significant difference between RPP group and corticosteroid group 12 weeks after injection, regarding VAS, ASES, CMS and SST in favor of the RPP group. MRI showed an overall slight nonsignificant improvement in grades of tendinopathy/tear in both groups, however, without statistically significant differences between the two groups.
  
  
  CONCLUSIONS
  PRP injections showed earlier better results as compared to corticosteroid injections, although statistically significant better results after 6 months could not be found. Therefore, subacromial RPP injection could be considered as a good alternative to corticosteroid injection, especially in patients with a contraindication to corticosteroid administration.
  
  
  METHODS
  II.
authors.affiliation: Orthopedic Surgery, Menofiya University, Al Minufya, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Shams
authors.affiliation: Pediatric Orthopedics, Tanta University, 13 Omar Zafan St., 6th Floor., Tanta, Gharbia, 3111, Egypt. mhosney2012@hotmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Sayed
authors.affiliation: Orthopedic Surgery, Menofiya University, Al Minufya, Egypt.
authors.forename: Osama
authors.initials: O
authors.lastname: Gamal
authors.affiliation: Pediatric Orthopedics, Tanta University, 13 Omar Zafan St., 6th Floor., Tanta, Gharbia, 3111, Egypt.
authors.forename: Waled
authors.initials: W
authors.lastname: Ewes
mesh_terms: D000328:Adult; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D053657:Platelet-Rich Plasma; D011788:Quality of Life; D016059:Range of Motion, Articular; D017006:Rotator Cuff; D000070636:Rotator Cuff Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D020069:Shoulder Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: Corticosteroid; Platelet-rich plasma; Rotator cuff; Shoulder pain; Subacromial impingement syndrome