Nonoperative Treatment of Rotator Cuff Disease With Platelet-Rich Plasma: A Systematic Review of Randomized Controlled Trials

Eoghan T. Hurley, Charles P. Hannon, Leo Pauzenberger, Daren Lim Fat, Cathal J. Moran, Hannan Mullett

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Purpose: To perform a systematic review of randomized controlled trials on the use of platelet-rich plasma (PRP)for nonoperative treatment of rotator cuff disease. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)guidelines, 2 reviewers independently screened the MEDLINE, Embase, and Cochrane Library databases for prospective, randomized controlled trials comparing PRP with a control in the nonoperative treatment of chronic rotator cuff disease for inclusion. Clinical data were extracted and evaluated. The quality of evidence was assessed using The Cochrane Collaboration risk-of-bias tool. Results: Five randomized controlled trials met the inclusion criteria, with 108 patients treated with PRP and 106 treated with a control. The mean age was 53.7 years, and 61.6% of patients were female patients. All of the studies found that the groups receiving PRP injections experienced improved clinical outcomes at final follow-up compared with baseline. Two studies found that PRP resulted in improved outcomes, mostly pain scores, compared with a control. One study compared PRP with formal exercise versus a saline solution injection with formal exercise therapy. It showed no difference in clinical outcomes between PRP and a saline solution injection when formal exercise therapy was used. Two other studies reported that PRP alone resulted in inferior outcomes to control groups receiving formal exercise therapy. Conclusions: The currently limited available evidence on PRP for nonoperative treatment of chronic rotator cuff disease suggests that in the short term, PRP injections may not be beneficial. When directly compared with exercise therapy, PRP does not result in superior functional outcomes, pain scores, or range of motion. However, interpretation of this literature is confounded by the lack of reporting of the cytology and characteristics of PRP. Level of Evidence: Level II, systematic review of Level I and II evidence.

Original languageEnglish
Pages (from-to)1584-1591
Number of pages8
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Issue number5
StatePublished - May 2019


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