What is rotator cuff injury?
Your shoulder is a ball and socket joint that connects your humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). The rotator cuff refers to the muscles and tendons that keep the shoulder in place, namely, the supraspinatus, infraspinatus, teres minor and subscapularis muscles and tendons that cover the head of the humerus.
The rotator cuff can be damaged from acute injury, or through progressive degeneration and overuse. The damage can range from muscle or tendon strain, to a tear of the rotator cuff tendons. Tears of the rotator cuff tendons can be partial or full-thickness.
What is the standard treatment of rotator cuff injury?
Conservative treatment options are preferred whenever possible for rotator cuff injury. If the injury is not too severe, it can be managed with a program of rest, ice therapy, compression and elevation. Analgesic medications can also be prescribed to relieve pain symptoms, as well as to reduce inflammation. Physical therapy and rehabilitation may be recommended to improve the strength and conditioning of the stabilizing muscles.
Patients suffering large or complete tears, or weakness and reduced functionality of the joint may require surgical intervention. While surgery usually results in decreased pain and improved function, significant failure rates are noted at long-term follow up consults. It is theorized that failure rates can be attributed to the poor vascularity and cellular infiltration of the tendon, leading to poor wound healing and repair.
How is PRP used in the treatment of rotator cuff injury?
Platelet-rich plasma therapy contains a high concentration of the following growth and repair factors:
- platelet-derived growth factor
- transforming growth factor beta
- fibroblast growth factor
- insulin-like growth factor 1
- insulin-like growth factor 2
- vascular endothelial growth factor
- epidermal growth factor
- Interleukin 8
- keratinocyte growth factor
- connective tissue growth factor
PRP is derived from the patient’s own blood: after drawing the necessary amount for PRP, the blood is concentrated in a centrifuge. The centrifuge splits the blood into three laters: (1) the top layer of plasma; (2) the platelets and white blood cells (also known as “the buffy coat”); and (3) the red blood cells. It is the second layer that is used for PRP.
PRP injections may be anywhere from three to eight times as concentrated as normal blood. This will be injected into the damaged area to stimulate growth and regeneration of health tissue, as well as to promote increased blood supply and tissue repair.
Should I get PRP for my rotator cuff injury?
The proponents of PRP claim that this intervention allows the body to recover within a shorter period of time compared to routine treatment. Early clinical trials have also shown that PRP can be effective in reducing pain and improving function. However, PRP still remains in its experimental stage, and there are no large-scale studies that have clearly demonstrated its effectiveness and safety. PRP should be considered an experimental procedure that can be chosen if the standard treatment options have already failed.
R3 Stem Cell’s Centers of Excellence offer PRP therapy for shoulder conditions of all types, call us today for top treatment!
Barber FA. Platelet-rich plasma for rotator cuff repair. Sports Med Arthrosc. 2013 Dec;21(4):199-205. doi: 10.1097/JSA.0b013e31828a7c6a.
Moraes VY, Lenza M, Tamaoki MJ, Faloppa F, Belloti JC. Platelet-rich therapies for musculoskeletal soft tissue injuries. Cochrane Database Syst Rev. 2014 Apr 29;4:CD010071. doi: 10.1002/14651858.CD010071.pub3.
Scarpone M, Rabago D, Snell E, et al. Effectiveness of Platelet-rich Plasma Injection for Rotator CuffTendinopathy: A Prospective Open-label Study. Glob Adv Health Med. 2013 Mar;2(2):26-31. doi: 10.7453/gahmj.2012.054.