SHOULDER ARTHROSCOPY

Q: I recently visited a physician for shoulder pain and was recommended a platelet rich plasma (PRP) injection instead of cortisone. Is this better and is it a good idea?

A: The treatment of shoulder pain, most commonly involving the rotator cuff, is multidimensional and often involves consideration of pain relieving injections into the area. Corticosteroid, or “cortisone,” injections have been the mainstay of such interventions for decades and have been found to be safe and effective for this purpose. Research remains ongoing to help better our understanding of the impacts of cortisone injections on the rotator cuff tendon and help inform practitioners and patients about what is appropriate in terms of dose and frequency of such injections. Suffice it to say that the results of this research remains somewhat inconclusive but indicates that use of cortisone injections for rotator cuff problems is not a one-sizefits-all approach and needs to be individualized for each patient. At the same time, there continues to be tremendous interest in exploring alternatives to traditional cortisone shots for rotator cuff problems. Chief among these alternatives is platelet rich plasma. PRP is a blood product collected from the patient or a donor (from a blood bank) which theoretically is rich with a concentration of platelets that may provide some benefit in terms of healing or reduction in inflammation. Unfortunately, up to this point the research on PRP has yielded mixed results on its effectiveness in this setting. A study published in the December 2020 issue of The Journal of Bone and Joint Surgery by Jo et al, randomly assigned patients with rotator cuff pain to receive either a cortisone injection or a PRP injection. This sort of randomized controlled trial is the gold standard in medical research to help minimize bias within a study. The investigators concluded that PRP injections provided no superiority in terms of symptom relief from rotator cuff disorders than did cortisone shots. When considering the significantly higher costs of PRP treatments this should lead to further caution in adopting them as a treatment alternative in rotator cuff disease.

To learn more about rotator cuff disorders visit ohioshouldercenter.com

Eric M. Parsons, M.D.

Ohio Shoulder Center for Arthroscopy Lake Orthopaedic

Associates, Inc. 36060 Euclid Ave., Suite 104 Willoughby 440-942-1050 9500 Mentor Ave., Suite 210

Mentor 440-352-1711 www.ohioshouldercenter.com