Platelet-Rich Plasma for Partial Rotator Cuff Tears

Summary

The goal of this clinical trial is to learn whether platelet-rich plasma (PRP) injection, made from a participant's own blood, can help heal the tendon and improve shoulder symptoms in people with partial tears of the supraspinatus tendon. The main questions it aims to answer are: * Does PRP help the tendon heal? * Does PRP improve pain, shoulder movement, daily function, and shoulder magnetic resonance imaging (MRI) findings? Researchers will compare PRP plus standard of care (physical therapy) to standard of care alone to see if PRP leads to better healing and better clinical results. Researchers will also study if differences in specific biomolecules in PRP are associated with differences in treatment response. Participants will: * receive standard of care treatment, with or without PRP injection depending on the study group * have blood collected for PRP preparation * have their pain, shoulder movement, and shoulder function assessed * undergo shoulder MRI scans * be followed over time to measure healing and symptom improvement

Timeline

Start

2026-06-01

Primary completion

2029-06-01

Completion

2029-12-01

Publications

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• Background LaPrade RF, Geeslin AG, Murray IR, Musahl V, Zlotnicki JP, Petrigliano F, Mann BJ. Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 1: Biologics Overview, Ligament Injury, Tendinopathy. Am J Sports Med. 2016 Dec;44(12):3270-3283. doi: 10.1177/0363546516634674. Epub 2016 Mar 29.
• Background Tanpowpong T, Thepsoparn M, Numkarunarunrote N, Itthipanichpong T, Limskul D, Thanphraisan P. Effects of Platelet-Rich Plasma in Tear Size Reduction in Partial-Thickness Tear of the Supraspinatus Tendon Compared to Corticosteroids Injection. Sports Med Open. 2023 Feb 8;9(1):11. doi: 10.1186/s40798-023-00556-w.
• Background Somisetty TK, Seenappa H, Das S, Shanthappa AH. Comparing the Efficacy of Intra-articular Platelet-Rich Plasma and Corticosteroid Injections in the Management of Frozen Shoulder: A Randomized Controlled Trial. Cureus. 2023 May 30;15(5):e39728. doi: 10.7759/cureus.39728. eCollection 2023 May.
• Background Sanchez-Losilla C, Ferre-Aniorte A, Alvarez-Diaz P, Barastegui-Fernandez D, Cugat R, Alentorn-Geli E. Efficacy of platelet-rich plasma in rotator cuff repair: systematic review and meta-analysis. Rev Esp Cir Ortop Traumatol. 2024 May-Jun;68(3):296-305. doi: 10.1016/j.recot.2023.05.014. Epub 2023 Jun 1. English, Spanish.
• Background Woo SL, Gelberman RH, Cobb NG, Amiel D, Lothringer K, Akeson WH. The importance of controlled passive mobilization on flexor tendon healing. A biomechanical study. Acta Orthop Scand. 1981 Dec;52(6):615-22. doi: 10.3109/17453678108992156.
• Background Trantos IA, Vasiliadis ES, Giannoulis FS, Pappa E, Kakridonis F, Pneumaticos SG. The Effect of PRP Augmentation of Arthroscopic Repairs of Shoulder Rotator Cuff Tears on Postoperative Clinical Scores and Retear Rates: A Systematic Review and Meta-Analysis. J Clin Med. 2023 Jan 11;12(2):581. doi: 10.3390/jcm12020581.
• Background Velasquez Garcia A, Ingala Martini L, Franco Abache A, Abdo G. Role of platelet-rich plasma in the treatment of rotator cuff tendinopathy. World J Orthop. 2023 Jul 18;14(7):505-515. doi: 10.5312/wjo.v14.i7.505. eCollection 2023 Jul 18.
• Background Adra M, El Ghazal N, Nakanishi H, Smayra K, Hong SS, Miangul S, Matar RH, Than CA, Tennent D. Platelet-rich plasma versus corticosteroid injections in the management of patients with rotator cuff disease: A systematic review and meta-analysis. J Orthop Res. 2023 Jan;41(1):7-20. doi: 10.1002/jor.25463. Epub 2022 Oct 31.
• Background Jiang X, Zhang H, Wu Q, Chen Y, Jiang T. Comparison of three common shoulder injections for rotator cuff tears: a systematic review and network meta-analysis. J Orthop Surg Res. 2023 Apr 3;18(1):272. doi: 10.1186/s13018-023-03747-z.
• Background Filardo G, Di Matteo B, Kon E, Merli G, Marcacci M. Platelet-rich plasma in tendon-related disorders: results and indications. Knee Surg Sports Traumatol Arthrosc. 2018 Jul;26(7):1984-1999. doi: 10.1007/s00167-016-4261-4. Epub 2016 Sep 24.
• Background Thomopoulos S, Kim HM, Das R, Silva MJ, Sakiyama-Elbert S, Amiel D, Gelberman RH. The effects of exogenous basic fibroblast growth factor on intrasynovial flexor tendon healing in a canine model. J Bone Joint Surg Am. 2010 Oct 6;92(13):2285-93. doi: 10.2106/JBJS.I.01601.
• Background Thomopoulos S, Das R, Silva MJ, Sakiyama-Elbert S, Harwood FL, Zampiakis E, Kim HM, Amiel D, Gelberman RH. Enhanced flexor tendon healing through controlled delivery of PDGF-BB. J Orthop Res. 2009 Sep;27(9):1209-15. doi: 10.1002/jor.20875.
• Background Giusti I, Rughetti A, D'Ascenzo S, Millimaggi D, Pavan A, Dell'Orso L, Dolo V. Identification of an optimal concentration of platelet gel for promoting angiogenesis in human endothelial cells. Transfusion. 2009 Apr;49(4):771-8. doi: 10.1111/j.1537-2995.2008.02033.x. Epub 2008 Dec 23.
• Background Dohan Ehrenfest DM, Andia I, Zumstein MA, Zhang CQ, Pinto NR, Bielecki T. Classification of platelet concentrates (Platelet-Rich Plasma-PRP, Platelet-Rich Fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J. 2014 May 8;4(1):3-9. eCollection 2014 Jan.
• Background Deng D, Wang W, Wang B, Zhang P, Zhou G, Zhang WJ, Cao Y, Liu W. Repair of Achilles tendon defect with autologous ASCs engineered tendon in a rabbit model. Biomaterials. 2014 Oct;35(31):8801-8809. doi: 10.1016/j.biomaterials.2014.06.058. Epub 2014 Jul 25.
• Background Lu J, Jiang L, Chen Y, Lyu K, Zhu B, Li Y, Liu X, Liu X, Long L, Wang X, Xu H, Wang D, Li S. The Functions and Mechanisms of Basic Fibroblast Growth Factor in Tendon Repair. Front Physiol. 2022 Jun 13;13:852795. doi: 10.3389/fphys.2022.852795. eCollection 2022.
• Background Subramanian A, Kanzaki LF, Galloway JL, Schilling TF. Mechanical force regulates tendon extracellular matrix organization and tenocyte morphogenesis through TGFbeta signaling. Elife. 2018 Nov 26;7:e38069. doi: 10.7554/eLife.38069.
• Background Lichtnekert J, Kawakami T, Parks WC, Duffield JS. Changes in macrophage phenotype as the immune response evolves. Curr Opin Pharmacol. 2013 Aug;13(4):555-64. doi: 10.1016/j.coph.2013.05.013. Epub 2013 Jun 7.
• Background Thomopoulos S, Parks WC, Rifkin DB, Derwin KA. Mechanisms of tendon injury and repair. J Orthop Res. 2015 Jun;33(6):832-9. doi: 10.1002/jor.22806. Epub 2015 Mar 2.
• Background Zhou T, Han C, Weng X. Present situation and development prospects of the diagnosis and treatment of rotator cuff tears. Front Surg. 2023 Jun 27;10:857821. doi: 10.3389/fsurg.2023.857821. eCollection 2023.
• Background Lukasiewicz P, McFarland EG, Weber SC. Partial rotator cuff tears: algorithmic approach to treatment. Ann Jt. 2023 Jun 12;8:21. doi: 10.21037/aoj-22-38. eCollection 2023. No abstract available.
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• Background Snedeker JG, Foolen J. Tendon injury and repair - A perspective on the basic mechanisms of tendon disease and future clinical therapy. Acta Biomater. 2017 Nov;63:18-36. doi: 10.1016/j.actbio.2017.08.032. Epub 2017 Sep 1.

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