Platelet‐rich plasma provides modest but durable functional benefit over corticosteroid for rotator cuff tendinopathy: A systematic review and meta‐analysis of randomized controlled trials

Purpose To compare platelet‐rich plasma (PRP) and corticosteroid (CS) injections in rotator cuff tendinopathy and partial‐thickness tears. Methods A systematic review was conducted. Eligible studies were randomized controlled trials (RCTs) of adults (≥18 years) with rotator cuff tendinopathy or partial tears comparing PRP with CS injections. Primary outcomes were pain, patient‐reported outcome scores and adverse events. Random‐effects meta‐analyses were performed using mean difference (MD) or risk ratio (RR) with 95% confidence intervals (CIs). Results Ten RCTs ( n = 591) were included. At 3‐ to 6‐week and 3‐month follow‐up, pain and patient‐reported outcomes did not differ significantly between groups. At 6 months, PRP demonstrated clearer benefits. PRP improved American Shoulder and Elbow Surgeons score (ASES) (MD + 10.8, 95% CI: 4.71–16.80, p = 0.0005) and Constant–Murley score (CMS) (MD + 10.7, 95% CI: 1.21–20.27, p = 0.027). Pain reduction at 6 months favoured PRP (pain visual analogue scale [VAS] MD −0.8, 95% CI: −1.45 to −0.18, p = 0.012). PRP was associated with fewer adverse events (RR 0.66, 95% CI: 0.44–0.99, p = 0.047). Conclusions PRP injections offer statistically significant, although clinically modest, improvements in pain and shoulder function compared with CS injections and are associated with fewer adverse events at 6 months. Taken together, these findings suggest that PRP may serve as a more durable treatment option for patients with rotator cuff tendinopathy. Level of Evidence Level I.