Complications Related to the Administration of Platelet-Rich Plasma in The Treatment Of Rotator Cuff Lesions: A Critical Review of The Literature

Platelet-rich plasma (PRP) has been used in the conservative treatment of tendinopathies and partial-thickness rotator cuff tears, as well as a biological adjunct during surgical repair. Because it is generally prepared from the patient's own blood, the procedure was initially regarded as low risk, and it was frequently claimed that it did not cause clinically relevant complications. This perception, however, should be interpreted with caution. Although clinical studies have reported few serious adverse events, exacerbated inflammatory pain, edema, hematoma, reactive bursitis, infection, injuries related to improper needle positioning, structural worsening of the lesion, and shoulder stiffness may occur. Evidence published in 2026 identified an overall incidence of complications similar to that observed with other injections, but a significantly higher frequency of adhesive capsulitis among patients treated with PRP. PRP should therefore not be considered a risk-free procedure. Its indication should be judicious and accompanied by informed consent, documentation of product composition, a description of the application technique, and post-procedure clinical follow-up.