Summary

PRP injection in our small study group showed good results in rotator cuff tendinitis with improvement in both the VAS and the constant shoulder scores.

Abstract

Introduction

Rotator cuff tendinitis is a significant source of disability and can limit daily activities because of pain. Rotator cuff tendinitis has been treated using various methods including physiotherapy, steroid injections and recently platelet rich plasma (PRP). There is no clear consensus over the benefit of using PRP for tendinitis, with some studies reporting a clear benefit while other studies reporting no more benefit than the controls. We decided to study the effect of PRP in rotator cuff tendinitis. Methods: Patients with shoulder pain for more than 3 months not responding to NSAIDs or physiotherapy with a diagnosis of Rotator cuff tendinitis, which was confirmed by MRI, were included in the study. Patients with rotator cuff tear or any other shoulder pathology were excluded. All patients had a full passive ROM. We included a total of 40 patients. The age of the patients were between 20 and 60 years. We did a simple randomisation. 21 patients received 5ml of PRP injection in the subacromial space and 19 patients received steroid (40mg of Triamcinolone) injection in the subacromial space. All patients then underwent a 6-week exercise program. The patients were followed up at 3 weeks, 6 weeks, 3 months, 6 months and at 1 year. Visual Analog scale was used to assess pain and the Constant shoulder score was calculated both pre and post injection. Results: The mean Constant score in the PRP group was 47.8 pre injection which improve to 77.3 at the time of final follow up. In the steroid group the mean constant score was 51.6 pre injection which improved to a mean of 70.3 at the time of final follow up. The improvement in the Constant score was more in the PRP group as compared to the steroid group and this was found to be statistically significant (p<0.05). There was a significant improvement of VAS scores in both groups. The pre injection VAS score in the PRP group was a mean of 8.2, which improved to a mean of 3.3 post injection at the final follow up. In the steroid group the mean pre injection VAS score was 8.6, which improved to a mean of 3.6 at the time of the final follow up.

Conclusion

PRP injection in our small study group showed good results in rotator cuff tendinitis with improvement in both the VAS and the constant shoulder scores. Randomised control trials with a larger number of patients need to be carried out to establish the efficacy of PRP in the management of rotator cuff tendinitis.