Platelet-rich plasma (PRP) therapy for rotator cuff tears is a treatment option that has shown promise, but its effectiveness varies based on the type of tear, severity, and patient-specific factors. PRP is an injection of a concentrated form of platelets derived from the patient’s own blood, which is believed to enhance healing by releasing growth factors that aid tissue repair.
How PRP Works for Rotator Cuff Tears:
- Growth Factors: PRP contains growth factors that can stimulate tissue healing, reduce inflammation, and promote regeneration of damaged tissues.
- Improving Healing: PRP is thought to aid in the healing of small or partial-thickness tears of the rotator cuff by stimulating the body’s natural healing processes.
- Reduced Inflammation: It may help reduce pain and inflammation, which can improve mobility and function.
Effectiveness of PRP for Rotator Cuff Tears:
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Partial-Thickness Tears:
- PRP has shown more promising results in partial-thickness tears of the rotator cuff, where the tear is not fully through the tendon. In these cases, PRP may promote healing and help reduce symptoms without the need for surgery.
- Studies suggest that PRP may accelerate recovery and reduce pain in the short to medium term, especially when used alongside physical therapy.
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Full-Thickness Tears:
- For full-thickness tears (complete ruptures of the tendon), the evidence for PRP is less clear. In these cases, PRP is typically used as an adjunct to surgical repair rather than as a standalone treatment. PRP injections may help improve healing after surgery, but it is unlikely to fully heal a complete tear on its own.
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Surgical Repair Adjunct:
- PRP is sometimes used to supplement surgical repair of rotator cuff tears, with the idea that it may enhance the biological healing response post-surgery. Some studies have shown improved tendon healing and reduced re-tear rates when PRP is used during or after surgery, but other studies have shown mixed results.
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Chronic Tears and Tendinosis:
- In cases of chronic rotator cuff tendinosis (degeneration of the tendon without a full tear), PRP may help improve symptoms by reducing inflammation and stimulating tissue repair.
What the Research Says:
- Research on PRP for rotator cuff tears is mixed, with some studies showing beneficial outcomes, particularly for pain reduction and functional improvement, and others showing no significant differences compared to standard treatments like physical therapy or corticosteroid injections.
- A 2021 meta-analysis of studies on PRP for rotator cuff repair found that it may reduce post-operative pain and potentially improve healing quality, but the long-term benefits were still uncertain.
Considerations:
- Severity of the Tear: PRP is more likely to benefit small or partial-thickness tears, while full-thickness tears may still require surgery.
- Adjunct to Other Treatments: PRP is usually not a standalone treatment for more severe injuries. It may be combined with other interventions like physical therapy or surgery.
- Individual Response: The effectiveness of PRP can vary widely between individuals, and some may experience better outcomes than others.
Conclusion:
PRP may be helpful for treating partial rotator cuff tears, reducing inflammation, and promoting tissue healing, especially when combined with physical therapy or post-surgical repair. However, for full-thickness tears, PRP is usually an adjunct to surgery rather than a primary treatment. Discuss with your orthopedic surgeon or healthcare provider to determine if PRP is a suitable option for your specific injury.
Author
Dr. Catherine Logan, MD, MBA
Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.
