Patient-Oriented Evidence That Matters

Platelet-Rich Plasma Injection Not Beneficial for Nonoperative Treatment of Rotator Cuff Disease


Am Fam Physician. 2019 Nov 15;100(10):647-648.

Clinical Question

Are platelet-rich plasma injections beneficial in the nonoperative treatment of rotator cuff disease in adults?

Bottom Line

The review found no evidence that supports any additional benefit of platelet-rich plasma injections compared with various control interventions, including saline placebo, in the non-operative treatment of rotator cuff disease in adults. Exercise therapy was shown to be superior to platelet-rich plasma injections in improving outcomes in the included studies. (Level of Evidence = 1a)


The benefits of platelet-rich plasma injections in the management of various tendinopathies are inconsistent. The investigators searched Medline, Embase, and the Cochrane Library for English-language–only randomized controlled trials that compared platelet-rich plasma injections with control treatments in adults with chronic rotator cuff disease. Two reviewers used a standard evaluation tool to independently analyze individual articles for inclusion criteria and risk of bias. Discrepancies were resolved after consensus discussion with a third reviewer. Five studies (N = 214) met inclusion criteria, with one considered at low risk, three at moderate risk, and one at high risk of bias. Various controls included corticosteroid injection, dry needling, saline solution injection, and formal exercise therapy. At follow-up (range of six to 12 months), no differences occurred between active treatment with platelet-rich plasma injections and any of the control interventions for pain scores, disability measures, or range of motion. In the two studies in which platelet-rich plasma injections alone were used in the treatment group, the control group receiving exercise therapy had superior clinical outcomes.

Study design: Systematic review

Funding source: Unknown/not stated

Setting: Various (meta-analysis)

Reference: Hurley ET, Hannon CP, Pauzenberger L, et al. Nonoperative treatment of rotator cuff disease with platelet-rich plasma: a systematic review of randomized controlled trials. Arthroscopy. 2019;35(5):1584–1591.

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.

A collection of POEMs published in AFP is available at https://www.aafp.org/afp/poems.



Want to use this article elsewhere? Get Permissions

More in AFP

Editor's Collections

Related Content

More in Pubmed


May 2022

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article