In vivo clinical and radiological effects of platelet-rich plasma on interstitial supraspinatus lesion: Case series.
Rotator cuff tear (RCT) is a frequent condition of clinical relevance that can be managed with a symptomatic conservative treatment, but surgery is often needed. Biological components like leukocytes and platelet rich plasma (L-PRP) could represent an alternative curative method for interstitial RCT.



It has been hypothesized that an ultrasound guided L-PRP injection in supraspinatus interstitial RCT could induce radiological healing.



A prospective case series including 25 patients was performed in order to assess the effect of L-PRP infiltration into supraspinatus interstitial RCTs. Primary outcome was tear size change determined by magnetic resonance imaging arthrogram (MRA) before and 6 months after L-PRP infiltration. Secondary outcomes were Constant score, SANE score, and pain visual analog scale (VAS) after L-PRP infiltration.



Tear volume diminution was statistically significant (P=.007), and a >50% tear volume diminution was observed in 15 patients. A statistically significant improvement of Constant score (P<.001), SANE score (P=.001), and VAS (P<.001) was observed. In 21 patients, Constant score improvement reached the minimal clinical important difference of 10.4 points.



We observed a statistically significant and clinically relevant effect on RCT size and clinical parameters after L-PRP infiltration. Such an important improvement of supraspinatus interstitial RCT with conservative management is uncommon, therefore intratendinous L-PRP infiltrations could have been beneficial. This encouraging result could pave the way for future randomized studies in order to formally determinate whether L-PRP infiltrations are a possible alternative to surgical treatment of interstitial RCT.



Prospective observational study; Level of evidence II.
Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.D. Maillard 3, 1217 Meyrin, Switzerland; Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland. Electronic address: Alexandre.laedermann@gmail.com.
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Lädermann
Shoulder, Elbow & Orthopaedic Sports Medicine, Department of Orthopaedics and Traumatology University Hospital Bern, Inselspital, 3010 Bern, Switzerland. Electronic address: m.zumstein@me.com.
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Zumstein
Department of Radiology, Geneva University Hospitals, Geneva, Switzerland. Electronic address: kolofrank@me.com.
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Kolo
Division of sports medicine, La Tour Hospital, Rue J.D. Maillard 3, 1217 Meyrin, Switzerland. Electronic address: maxime.grosclaude@latour.ch.
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Grosclaude
Division of sports medicine, La Tour Hospital, Rue J.D. Maillard 3, 1217 Meyrin, Switzerland. Electronic address: laurent.koglin@latour.ch.
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Koglin
Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Rue J.D. Maillard 3, 1217 Meyrin, Switzerland. Electronic address: adrien.schwitzguebel@latour.ch.
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Schwitzguebel
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D011859:Radiography; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
Growth factor; Leukocyte rich-platelet-rich plasma (L-PRP); Platelets; Rotator cuff lesion; Supraspinatus