Systematic review and meta-analysis of non-operative platelet-rich plasma shoulder injections for rotator cuff pathology.

MedStar author(s):
Citation: Pm & R. 2020 Nov 01PMID: 33131197Institution: MedStar National Rehabilitation NetworkForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020ISSN:
  • 1934-1482
Name of journal: PM & R : the journal of injury, function, and rehabilitationAbstract: BACKGROUND: Platelet-rich plasma (PRP) injections have been introduced to augment the recovery of patients with shoulder pathology. While multiple studies have been published, no large-scale trials or meta-analyses have assessed the efficacy of non-operative shoulder PRP injection.CONCLUSION: There is a limited quantity of high-quality studies that assess the efficacy of non-operative PRP shoulder injection for pain and ROM. Systematic review of PRP injections did not demonstrate an improvement in pain or ROM compared to physical therapy. While within-group meta-analysis of non-operative PRP statistically showed that non-operative PRP improved pain, the lack of adequate negative controls precludes the ability to conclude whether improvements were due to natural recovery or non-operative PRP. This article is protected by copyright. All rights reserved. Copyright This article is protected by copyright. All rights reserved.DESIGN: Two authors independently screened the Medline and Cochrane databases to include prospective studies that reported VAS and ROM outcomes for non-operative shoulder PRP injections for rotator cuff pathology. Study quality was assessed using the revised Cochrane Collaboration risk-of-bias tool and modified Downs and Black checklist. Subsequent meta-analysis was performed to determine the effect of non-operative PRP injections on pain and ROM 3 to 12 months post-intervention.OBJECTIVE: To assess the efficacy of non-operative PRP shoulder injection in rotator cuff pathology for pain as measured by the visual analog scale (VAS) and range of motion (ROM).RESULTS: Six studies met systematic review criteria. The included studies used different PRP formulations (concentration, leukocyte count), injection protocols (approach, injection number), and varied study designs. Three studies concluded that PRP provided no significant benefit for pain and ROM when compared to physical therapy. Within-group meta-analysis of six fairly heterogeneous studies (I2 77.8%) demonstrated a statistically significant (p < .001) improvement in pain 3 to 12 months after PRP injection. Within-group meta-analysis for four studies for shoulder flexion and abduction was found to be too heterogeneous to derive meaningful results.All authors: Ashfaq M, Brandstater M, Lui M, Shih W, Tran D, Yim NFiscal year: FY2021Digital Object Identifier: Date added to catalog: 2020-12-29
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 33131197 Available 33131197

BACKGROUND: Platelet-rich plasma (PRP) injections have been introduced to augment the recovery of patients with shoulder pathology. While multiple studies have been published, no large-scale trials or meta-analyses have assessed the efficacy of non-operative shoulder PRP injection.

CONCLUSION: There is a limited quantity of high-quality studies that assess the efficacy of non-operative PRP shoulder injection for pain and ROM. Systematic review of PRP injections did not demonstrate an improvement in pain or ROM compared to physical therapy. While within-group meta-analysis of non-operative PRP statistically showed that non-operative PRP improved pain, the lack of adequate negative controls precludes the ability to conclude whether improvements were due to natural recovery or non-operative PRP. This article is protected by copyright. All rights reserved. Copyright This article is protected by copyright. All rights reserved.

DESIGN: Two authors independently screened the Medline and Cochrane databases to include prospective studies that reported VAS and ROM outcomes for non-operative shoulder PRP injections for rotator cuff pathology. Study quality was assessed using the revised Cochrane Collaboration risk-of-bias tool and modified Downs and Black checklist. Subsequent meta-analysis was performed to determine the effect of non-operative PRP injections on pain and ROM 3 to 12 months post-intervention.

OBJECTIVE: To assess the efficacy of non-operative PRP shoulder injection in rotator cuff pathology for pain as measured by the visual analog scale (VAS) and range of motion (ROM).

RESULTS: Six studies met systematic review criteria. The included studies used different PRP formulations (concentration, leukocyte count), injection protocols (approach, injection number), and varied study designs. Three studies concluded that PRP provided no significant benefit for pain and ROM when compared to physical therapy. Within-group meta-analysis of six fairly heterogeneous studies (I2 77.8%) demonstrated a statistically significant (p < .001) improvement in pain 3 to 12 months after PRP injection. Within-group meta-analysis for four studies for shoulder flexion and abduction was found to be too heterogeneous to derive meaningful results.

English

Powered by Koha