Title : Platelet-rich plasma (PRP) injections vs Corticosteroid injections for the non-operative treatment of rotator cuff tendinopathy: A Systematic review and Meta-analysis
Abstract:
Recent guidelines advise the use of Corticosteroid (CS) injections in the non-operative management of rotator cuff tendinopathies (RCTs). Platelet-rich plasma (PRP) injections have been suggested as an alternative, but consensus has not been reached regarding efficacy. This meta-analysis aims to compare the functional score and pain outcomes between CS and PRP injections in patients with RCTs.
This review adhered to PRISMA guidelines and was prospectively registered on PROSPERO (CRD42024604934). A literature search and screening, conducted in November 2024, identified studies meeting a preregistered criterion. Functional and pain outcomes were extracted, pooled and reported as standardized or mean differences with 95% confidence intervals.
Sixteen randomized controlled trials (n=887) were included. Functional scores showed no significant differences between PRP and CS at 3–5 weeks (n=500, SMD=-0.26, 95% CI=-0.89 to 0.38, p=0.38) or 11–15 weeks (n=702, SMD=0.58, 95% CI=-0.07 to 1.23, p=0.0742). PRP showed greater improvement at 16–24 weeks (n=522, SMD=1.17, 95% CI=0.35 to 2.00, p=0.0107) and non-significant improvement beyond 24 weeks (n=278, SMD=0.95, 95% CI=-1.19 to 3.08, p=0.20).
Pain outcomes favoured CS at 3–5 weeks but were non-significant (n=340, MD=0.75, 95% CI=-0.28 to 1.78, p=0.1186). PRP showed greater, non-significant pain reduction at 11–15 weeks (n=446, MD=-0.5, 95% CI=-2.05 to 1.06, p=0.4674) and beyond 24 weeks (n=199, MD=-0.48, 95% CI=-3.84 to 2.87, p=0.23).
The findings suggest PRP may offer greater long-term benefits, with significant functional improvement seen at 16–24 weeks. High heterogeneity and inconsistent results highlight the need for standardization to assess PRP's efficacy against CS injections.
