PLoS One. 2016 Feb 5;11(2):e0147842. doi: 10.1371/journal.pone.0147842. eCollection 2016.

Abstract

OBJECTIVE:

This pilot study aimed to inform future research evaluating the effectiveness of Platelet Rich Plasma (PRP) injection for tendinopathy.

DESIGN:

Randomized control trial (RCT) and synchronous observational cohort studies. For the RCT, consecutive consenting patients treated at an academic sports medicine clinic were randomly assigned to either a PRP or placebo control group.

SETTING:

The Glen Sather Sport Medicine Clinic, Edmonton, Canada.

PATIENTS:

The RCT included 9 participants with rotator cuff tendinopathy. The cohort study included 178 participants with a variety of tendinopathies.

INTERVENTIONS:

Patients receiving PRP were injected with 4 ml of platelets into the supraspinatus and/or infraspinatus, while patients in the placebo group were injected with 4ml of saline. All participants undertook a 3-month standardized, home-based, daily exercise program.

MAIN OUTCOME MEASURES:

Participants in the RCT were re-evaluated 3, and 6 months post-injection. Change scores before and after injection on pain, disability and MRI-documented pathology outcomes were compared. In the cohort study, pain and disability were measured at 1, 2 and 3 months post-injection.

RESULTS:

For the RCT, 7 participants received PRP and 2 received placebo injections. Patients receiving PRP reported clinically important improvements in pain (>1.5/10 on VAS), disability (>15 point DASH change), and tendon pathology while those receiving placebo injections did not. In the observational cohort, statistically and clinically significant improvements in pain and disability were observed.

CONCLUSION:

This pilot study provides information for planning future studies of PRP effectiveness. Preliminary results indicate intratendinous, ultrasound-guided PRP injection may lead to improvements in pain, function, and MRI-documented tendon pathology.

TRIAL REGISTRATION:

Controlled-Trials.com ISRCTN68341698.

 

Orthop Traumatol Surg Res. 2016 Feb;102(1):47-52. doi: 10.1016/j.otsr.2015.11.002. Epub 2016 Jan 7.