Role of Image-guided Platelet-rich Plasma Injection in the Management of Patients of Supraspinatus Tendon Tear.

Abstract

Introduction: Supraspinatus tendinopathy is a common reason for shoulder pain, with or without an associated cuff tear. Various modalities of treatment have been described in literature such as physiotherapy, analgesics, corticosteroid injection, surgical repair (open or arthroscopic), and platelet-rich plasma (PRP) injection. Recently, there has been an increasing trend of PRP injection for rotator cuff arthropathy. Hence, we conducted a study to assess the effectiveness of PRP injection under ultrasound (USG) guidance in patients with supraspinatus tear.

Materials and methods: Twenty-eight patients were divided into two groups: Group A (physiotherapy, n = 15) and Group B (PRP injection with USG guidance, n = 13). Pain (Visual Analog Score [VAS]) and function (Oxford Shoulder Score [OSS]) were evaluated at baseline, 1 week, 4 weeks, and 12 weeks.

Results: 28 patients were divided into two groups, i.e., Group A (15 pt) - physiotherapy and Group B (13 pt) - PRP injection. On the basis of the VAS, PRP group has better score at 1 and 4 weeks as the results were statistically significant while insignificant at 12 weeks. On the basis of OSS, PRP group has better score at 1 and 4 weeks as the results were statistically significant while insignificant at 12 weeks similar to VAS score.

Discussion: The findings on pain relief (VAS) generally agree that both methods offer short-term improvement, with PRP potentially having a slight edge. However, the long-term effects (beyond 3 months) are less clear. Similarly, physiotherapy shows promise in improving function (Oxford score) in the short term, while some PRP studies suggest sustained benefits, possibly dependent on the specific PRP formulation. Overall, the discussion highlights the need for further investigation into the long-term efficacy of PRP compared to physiotherapy for managing rotator cuff tears.

Conclusion: Improvement in function and relief in pain were better in PRP group when compared to conservative group but we found that PRP has no superior result as compared to conservative therapy in the management of rotator cuff tear.