Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions: A protocol for systematic review and meta-analysis: Erratum

Objectives:Rotator cuff tear is the leading cause of the decline in quality of life for older adults, but comparative evidence on treatment effectiveness is lacking. This study systematically reviewed the effects of various rotator cuff tear treatments through a Bayesian meta-analysis of the related randomized clinical trials (RCTs).Methods:We searched nine electronic databases for RCTs evaluating rotator cuff tear treatments from their inception through June 2017. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the National Institute for Health and Care Excellence-Decision Support Unit guidelines (Supplementary Table 1). Outcomes included functional improvement, pain one year after surgical treatment, and tendon structural integrity. The Bayesian network meta-analysis was applied for functional improvement and pain, based on an assumption of consistency and similarity. Tendon integrity was reported descriptively.Results:Fifteen RCTs were selected. Patients undergoing physiotherapy after open surgery showed statistically significant functional improvements compared with those undergoing physiotherapy only (mean differences, 9.1 [credible interval, 0.9–17.4]). Open surgery with physiotherapy was associated with a decrease in pain 1 year after treatment compared with when physiotherapy was combined with arthroscopic rotator cuff surgery, mini open surgery, platelet-rich plasma therapy, or physiotherapy alone (absolute value of mean difference 1.2 to 1.4). The tendon integrity results were inconsistent.Conclusions:Some surgical treatments were associated with significant improvement in function and pain, but evidence regarding their comparative effectiveness is still lacking. A well-designed RCT discussing functional and structural treatment outcomes is needed in future.

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Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2018-000506 ◽

2019 ◽

Vol 5 (1) ◽

pp. e000506 ◽

Cited By ~ 9

Author(s):

Simon Lafrance ◽

Patrick Doiron-Cadrin ◽

Marie Saulnier ◽

Martin Lamontagne ◽

Nathalie J Bureau ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Corticosteroid Injection ◽

Meta Analysis ◽

Bibliographic Databases ◽

Ultrasound Guided ◽

Calcific Tendinopathy ◽

Shockwave Therapy ◽

Randomised Control Trials

BackgroundRotator cuff calcific tendinopathy is characterised by the deposition of hydroxyapatite crystals in one of the rotator cuff tendons and can be managed by ultrasound-guided lavage. However, evidence regarding the efficacy of ultrasound-guided lavage for rotator cuff calcific tendinopathy remains inconclusive. The aim of this systematic review and meta-analysis is to update the available evidence on the efficacy of ultrasound-guided lavage in adults with rotator cuff calcific tendinopathy.MethodsA literature search was conducted up to April 2018 in four bibliographic databases to identify randomised control trials that compared ultrasound-guided lavage alone with other interventions to treat rotator cuff calcific tendinopathy. Randomised control trials were assessed with the Cochrane Risk of Bias Tool. Meta-analyses and/or qualitative synthesis of the evidence were performed.ResultsThree randomised control trials were included. Pooled results for pain (n=226) indicated that ultrasound-guided lavage may significantly decrease pain when compared with shockwave therapy, with a mean difference of −1.98 out of 10 points (95% CI −2.52 to −1.45) in the short term and of −1.84 (95% CI −2.63 to −1.04) in the long term. Based on one trial (n=25), ultrasound-guided lavage significantly improved function when compared with shockwave therapy (p<0.05). Based on another trial (n=48), the addition of ultrasound-guided lavage to a corticosteroid injection significantly improves function in the long term (p<0.05).ConclusionFor individuals with rotator cuff calcific tendinopathy, low-quality evidence suggests that ultrasound-guided lavage is more effective than shockwave therapy or a corticosteroid injection alone. Future trials could modify the present conclusions.Trial registration numberCRD42018095858.

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Platelet-rich plasma in the conservative treatment of painful tendinopathy: a systematic review and meta-analysis of controlled studies

British Medical Bulletin ◽

10.1093/bmb/ldu007 ◽

2014 ◽

Vol 110 (1) ◽

pp. 99-115 ◽

Cited By ~ 61

Author(s):

I. Andia ◽

P. M. Latorre ◽

M. C. Gomez ◽

N. Burgos-Alonso ◽

M. Abate ◽

...

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Platelet Rich Plasma ◽

Meta Analysis

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Conservative treatment of partial-thickness rotator cuff tears and tendinopathy with platelet-rich plasma: a systematic review and meta-analysis

10.1101/2020.12.19.20248575 ◽

2020 ◽

Author(s):

Xiao-Na Xiang ◽

Jie Deng ◽

Yan Liu ◽

Xi Yu ◽

Biao Cheng ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Platelet Rich Plasma ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Rotator Cuff Tears ◽

Short Term ◽

Partial Thickness ◽

And Function

AbstractPurposeTo assess the effect of platelet-rich plasma (PRP) as a conservative therapy on individuals with partial-thickness rotator cuff tears (PTRCs) or tendinopathy in terms of pain, and function.MethodsA systematic review and meta-analysis of randomized controlled trials were conducted. Short-term (6±1 months) and long-term (≥1 year) outcomes were analysed, including the visual analogue scale (VAS), Constant-Murley score (CMS), Shoulder Pain and Disability Index (SPADI), as well as American Shoulder and Elbow Surgeons (ASES) score. The weighted mean difference (MD) with 95% confidence interval (CI) was used.ResultsTen studies were eligible in this review, nine studies with 561 patients were included in this meta-analysis. The meta-analysis showed statistically significant differences in the decrease in short-term VAS (MD=-1.56; 95% CI -2.82 to -0.30), and increase in CMS (MD=16.48; 95% CI 12.57 to 20.40), and SPADI (MD=-18.78 95% CI -36.55 to -1.02). Nonetheless, no long-term effect was observed on pain and function, except CMS (MD=24.30). The results of mean important differences (MIDs) reached the minimal clinically important differences, except ASES. For subgroup analysis, short-term VAS scores were decreased in PRP-treated patients with double centrifugation (MD=-1.99), single injection (MD=-0.71) and post-injection rehabilitation (MD=-1.59).ConclusionPRP-treated patients with PTRCs and rotator cuff tendinopathy demonstrated improvements in pain and function, although the effect may not last for a long time. Overall, our results suggest that PRP may have positive clinical outcomes, but limited data, and study heterogeneity hinder firm conclusions.

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