Efficacy of Platelet-rich Plasma Injection Combined with Exercise versus Exercise Alone in the Treatment of Supraspinatus Partial Tears: A Randomised Controlled Trial

Background: Partial tears of the supraspinatus tendon are a common cause of shoulder pain and functional impairment. This randomised controlled trial aimed to compare the effects of platelet-rich plasma (PRP) injections combined with an exercise programme versus an exercise programme alone in managing partial supraspinatus tears. Methodology: This open-label, parallel-group study was conducted in the Department of Physical Medicine and Rehabilitation at AIIMS, Rishikesh. A total of 60 participants aged 18–65 years with clinically and radiologically confirmed supraspinatus tears were randomised into two groups: Group A received PRP injections with a structured exercise programme, while Group B followed the exercise programme alone. Outcome measures included pain reduction (Numeric Rating Scale [NRS]), functional improvement (Shoulder Pain and Disability Index [SPADI]) and radiological healing (ultrasonographic tear thickness). Assessments were conducted at baseline, 1 month and 3 months. The analysis included parametric tests such as repeated measures ANOVA, along with logistic regression to calculate odds ratios and the number needed to treat (NNT). Results: Both the groups demonstrated improvements over time in NRS, SPADI and tear thickness, with Group A showing significantly greater benefits. At 3 months, the mean NRS scores decreased to 1.75 ± 1.37 in Group A versus 3.95 ± 2.66 in Group B ( P = 0.003), while SPADI scores reduced to 9.95 ± 9.44 in Group A compared to 25.90 ± 31.44 in Group B ( P < 0.001). Ultrasonographic measures revealed significant tear healing in Group A compared to Group B for both transverse and longitudinal tear dimensions ( P < 0.005). Logistic regression analysis showed Group A participants were more likely to achieve >50% improvement (odds ratio = 3.76, NNT = 3.33). Conclusion: PRP injections combined with an exercise programme offer superior pain relief, functional recovery and radiological healing compared to exercise alone in the management of partial supraspinatus tears. These findings highlight the potential of PRP as an effective adjunctive therapy.