Platelet-Rich Plasma Injection in Non-Operative Treatment of Partial-Thickness Rotator Cuff Tears: A Systematic Review and Meta-Analysis.
Pengfei Zhu, Zhengchao Wang, Hongmei Li and 1 others
PMID 35892292WHAT IT FOUND
PRP injections eased pain and improved shoulder function more than placebo at every follow-up point in 641 people with partial-thickness rotator cuff tears, and more than steroid injections or physiotherapy at 8 to 12 weeks and past 24 weeks.
The authors call the result not robust.
Key findings
01Shoulder function improved more with PRP than with control at all three follow-up windows, and more than placebo injections at all three. Against steroid injection or physiotherapy the advantage was smaller and showed up at 8 to 12 weeks and beyond 24 weeks.
02Pain was lower with PRP than with control at 8 to 12 weeks and beyond 24 weeks, and lower than placebo at all three follow-up windows. Against steroid injection or physiotherapy, PRP was better for pain at 8 to 12 weeks and beyond 24 weeks.
03The main weaknesses across the included trials were how the treatment allocation was concealed and whether participants and outcome assessors were blinded; the authors say blinding is difficult when PRP has to be prepared from the patient's own blood.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 11 trials and 641 patients were pooled, and the authors state that this is too few to conclude that PRP is superior. Most trials were at unclear or high risk of bias for allocation concealment and for blinding of participants and outcome assessors; the authors note blinding is hard when PRP has to be drawn from the patient's own blood. The authors could not test for publication bias because no analysis contained 10 or more studies. The check for whether one weak study was driving the result was done only for shoulder function, not for pain, because the two removed trials contributed little to the pain analysis. The control groups were different treatments pooled together, 3 placebo injections and 8 steroid injections or physiotherapy, so what PRP is being compared with is not the same across the analysis. Heterogeneity between trials was large, which is why a random-effects model was used. No included trial analysed results by where the tear sat, so it is unknown whether PRP works equally for bursal-side, articular-side and intra-tendinous tears. Follow-up ranged from 3 months to more than 12 months across the included trials, and the measurement scales differed.
Declared interests
The text supplied contains no funding statement and no competing-interests declaration, so who paid for the work and what the authors declared is not stated in the material provided.
The easy way to misread this
Do not read this as evidence that PRP should replace physiotherapy or steroid injections. The review pooled only 11 small trials, most at unclear or high risk of bias for allocation concealment and blinding, it could not test for publication bias, and the authors themselves state that their conclusion is not sufficiently robust.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →