When and How to Use PRP for Rotator Cuff Tendinopathy and Partial-thickness Tears

You can learn from a good case series even on a topic that's seen a lot of RCTs

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Smart Practice: PRP may be helpful for patients with rotator cuff tendinopathy, but skip it for patients with partial-thickness cuff tears.

What’s the Claim?

A genuinely prospective study — not one of those retrospective jobs “based on prospectively gathered data” — found that a subacromial injection with leukocyte-rich PRP resulted in clinically important improvements in pain and function in the large majority of patients (85%) with either partial-thickness rotator cuff tears or rotator cuff tendinopathy. Patients with partial-thickness tears did not do as well, though, and one in five of them went on to have surgery. Since this study was prospective, that allowed them to employ clear and thoughtful patient selection criteria — the diagnosis was robustly made (standardized exam + MRI), and in order to be eligible for a jab of PRP, patients had to have tried three months of physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and at least one previous subacromial corticosteroid injection.

How’s It Stack Up?