To assess effectiveness of ultra-sound guided platelet-rich plasma infiltrations (PRP) on the supraspinatus interstitial tear healing.

Symptomatic interstitial superior rotator cuff tear management remains challenging, as conservative management is rarely fully effective, and surgical management requires a long recovery period of 6 months. PRP infiltration might thus represent a valuable alternative.

We conducted a randomized, double-blind, controlled trial involving 80 patients suffering from a symptomatic isolated supraspinatus tendon interstitial tear. Patients received two intratendinous injections separated by 1 month, of either PRP (n=41) or saline solution (n=39). The primary outcome was tear size evolution, measured on magnetic-resonance arthrogram performed at baseline and at month 7.

The tendon tear volume did not change between groups : 0mm³ (range : −84 to +41) for PRP group and 9.8mm³ (range : −264 to +270mm³) for saline group (P=0.175). Comparison between baseline and month 7 on the whole cohort showed a statistically significant decrease in median lesion size from 29mm³ (range : 4–301) to 19mm³ (range : 0–292) (P=0.0293), and a significant improvement for all the clinical scores (VAS, SANE, Constant, and ASES scores) (P>0.001). There were no between-group significant differences with respect to the clinical scores evolution. Main side effects identified were present on 26/80 patients (PRP : 18/41 ; control : 8/39 ; P=0.0256), and consisted of : significant pain following injections (PRP : 11/41 ; control : 6/39), frozen shoulder (PRP : 8/41 ; control : 3/39), development of bursal- or articular-tear pattern at month 7 (PRP : 4/41 ; control : 1/39). Nine patients had to benefit a surgical rotator cuff repair after month 7 (PRP : 7/41 ; control : 2/40 ; P=0.182).

PRP was not superior to saline injection regarding supraspinatus interstitial tear healing and clinical outcomes improvement. We observed a clinical and radiological improvement on the merged PRP and placebo groups between months 0 and 7. More side effects were observed on the PRP group. The potential costs of two PRP infiltrations are estimated as EURO 1100.