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Rotator Cuff Tears: PRP as a Non-Surgical Option


The rotator cuff, a group of four muscles surrounding the shoulder joint, plays a pivotal role in our ability to lift and rotate our arms. A tear in this crucial structure can lead to pain, weakness, and limited mobility. While surgery has long been a recommended treatment for severe rotator cuff tears, Platelet-Rich Plasma (PRP) therapy has emerged as an exciting non-surgical alternative for certain cases. However, it's essential to note that not all rotator cuff tears are alike, and some still necessitate surgical intervention.

Understanding Rotator Cuff Tears Rotator cuff tears can be either partial or full-thickness tears. These tears can result from:


  • Acute trauma, like lifting a heavy object

  • Repetitive arm motions (common in athletes and certain professions)

  • Gradual wear and tear due to aging


The symptoms usually involve pain, especially during overhead activities, weakness in the shoulder, and a crackling sensation when moving the shoulder in certain positions.


PRP as a Non-Surgical Treatment Platelet-Rich Plasma therapy involves drawing an amount of the patient's blood, processing it to concentrate the platelets, and then injecting it into the injured site. Here's why it's becoming a go-to treatment for some rotator cuff tears:

1. Natural Healing Boost: PRP is packed with growth factors that can accelerate tissue repair and reduce inflammation, offering both pain relief and healing. 2. Minimal Invasiveness: PRP injections are minimally invasive, reducing risks and recovery time. 3. Safety Profile: Using the patient's blood may minimize risks like allergic reactions as compared to more invasive complicated interventions.


When is Surgery Required? While PRP holds promise, it's not a universal solution for all rotator cuff tears. Here are common indications for rotator cuff surgery:

1. Large, Complex, or Retracted Tears: More significant full-thickness tears, those affecting multiple tendons, or cases where there is evident tendon retraction often necessitate surgical intervention for optimal recovery. 2. Acute Tears: Sudden tears resulting from trauma, especially in younger patients, may benefit more from surgery to restore full function. 3. Symptom Duration: Persistent symptoms lasting more than 6-9 months, despite non-surgical treatments, may indicate the need for surgical intervention. 4. Loss of Shoulder Strength: Significant weakness that affects daily activities and doesn't improve with therapy may be a surgical candidate. 5. Age and Activity Level Considerations: The suitability of PRP for rotator cuff tears is influenced by individual factors like age and activity level. Every case warrants a personalized assessment to determine the most appropriate treatment approach.


Conclusion:


While the potential of PRP therapy as a non-surgical approach is undoubtedly promising, it's of paramount importance to assess the treatment in the context of each individual's unique circumstances.

At Pain Experts, we emphasize in-depth evaluations, enabling our patients to make knowledgeable health choices. Should surgery be required, rest assured we collaborate with the region's leading surgeons to ensure optimal care. We appreciate patients who recognize the significance of prioritizing their health. With us, you are more than a patient—you're an integral part of your health journey. Deborah Westergaard, MD


Platelet-Rich Plasma in Patients With Partial-Thickness Rotator Cuff Tears or Tendinopathy Leads to Significantly Improved Short-Term Pain Relief and Function Compared With Corticosteroid Injection: A Double-Blind Randomized Controlled Trial

CoryA.Kwong,M.D.,FRCSC,JarretM.Woodmass,M.D.,FRCSC, EvaM.Gusnowski,M.D.,M.Sc.,FRCSC,AaronJ.Bois,M.D.,M.Sc.,FRCSC, JustinLeblanc,M.D.,M.Sc.,FRCSC,KristieD.More,M.Sc.,and IanK.Y.Lo,M.D.,FRCSC

Arthroscopy 2021 Feb;37(2):510-517


Sodium Hyaluronate and Platelet-Rich Plasma for Partial-Thickness Rotator Cuff Tears

YUCAI, ZHENXINGSUN ,BOKAILIAO ,ZHANQIANGSONG ,TINGXIAO1, and PENGFEIZHU5

Med Sci Sports Exerc 2019 Feb;51(2):227-233


Evidence for Utilization of Injectable Biologic Augmentation in Primary Rotator Cuff Repair: A Systematic Review of Data From 2010 to 2022

Orthop J Sports Med 2023 Feb 3

Subacromial Injection of Autologous Platelet-Rich Plasma versus Corticosteroid for the Treatment of Symptomatic Partial Rotator Cuff Tears

Shams A, El-Sayed M, Gamal O, Ewes W.

Eur J Orthop Surg Trauma 2016 Dec;26(8):837-842


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               Deborah Westergaard, MD

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