Plasma rich in growth factors versus corticosteroid injections for management of chronic rotator cuff tendinopathy: a prospective double-blind randomized controlled trial with 1 year of follow-up

Background: Rotator cuff tendinopathy (RCT) is a painful and dysfunctional shoulder condition traditionally considered as a ative pathology. However, evidence is pointing to immunocompetent cells and activated stromal fibroblasts as the drivers of solved inflammatory condition in RCT. As potent anti-inflammatory agents, corticosteroid injections have been among the and the most common therapeutic strategies. Recently, another adjuvant therapy to treat musculoskeletal inflammation-driven conditions, namely, platelet-rich plasma (PRP), has emerged as safe and effective. The aim of this study was to compare the efficacy of intratendinous injections of plasma rich in growth factors (PRGF) with conventional intratendinous corticosteroid on patients with chronic RCT using patient-reported outcome measures.Methods: A total of 39 patients received PRGF treatment (3 infiltrations, 1 every other week), whereas 40 patients, as a control received corticosteroid (3 infiltrations, 1 every other week). Patients were evaluated before treatment and at 3, 6, and 12 follow-up using the University of California Los Angeles (UCLA) scale, Quick Disabilities of the Arm, Shoulder and Hand DASH), and Constant test. The primary outcome of the study was a 15% superior improvement of the PRGF group compared the corticosteroid group in the UCLA scale and QuickDASH test at 6 months of follow-up, considering this difference to be relevant.Results: Both PRGF and corticosteroid groups showed significant clinical improvement in the 3 scores at all time points of compared with baseline. However, at 6 and 12 months of follow-up, the PRGF group had 22.1% and 21.2% superior improvement UCLA test, 14.3% and 13.5% for QuickDASH, and 16.4% and 20.2% for the Constant-Murley test, respectively, compared to costeroid group.Conclusions: Three PRGF intratendinous injections every other week in patients with chronic rotator cuff tendinopathy show signifi-cantly superior and sustained pain-relieving and functional improvements compared with corticosteroid intratendinous injections assessed by 3 patient-reported outcome scales at 6 and 12 months of follow-up. Level of evidence: Level I; Randomized Controlled Clinical Trial; Treatment Study (c) 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.