Injectable platelet-rich fibrin versus subacromial corticosteroid injection in the management of symptomatic partial thickness rotator cuff tears

Background Partial thickness rotator cuff tears (PTRCT) are a leading cause of refractory shoulder pain. Subacromial corticosteroid (CS) injection provides short-term relief but may compromise tendon integrity. Injectable platelet-rich fibrin (iPRF), a second-generation autologous biologic, theoretically promotes healing through sustained growth factor release. Objective To compare the efficacy of iPRF with CS injection on pain and shoulder function over 12 months in symptomatic PTRCTs. Methods In this study 69 patients with PTRCT confirmed by magnetic resonance imaging (MRI) were prospectively allocated to a single subacromial injection of iPRF (group 1, n = 37) or 40 mg methylprednisolone with 1% lignocaine (group 2, n = 32). The iPRF was prepared by centrifuging 10 mL of autologous blood at 700 rpm for 3 min. Visual analogue scale (VAS) and disabilities of the arm, shoulder and hand (DASH) scores were recorded at day 0 and at 1, 6 and 12 months. Of the patients 3 in the iPRF arm were lost to follow-up so that 34 and 32 patients, respectively could be analyzed. Results Baseline demographics and scores were comparable ( p > 0.05). At 1 month, both groups showed comparable improvement (VAS 4.09 vs. 3.69; p = 0.23). By 6 and 12 months, iPRF showed significantly superior outcomes: VAS at 12 months 1.81 ± 1.24 vs. 5.18 ± 1.46 and DASH 18.4 ± 9.8 vs. 44.9 ± 9.8 (both p < 0.001). Responder rate (≥ 50% VAS reduction) at 12 months was 97.1% in iPRF vs. 6.3% in CS. No major complications occurred. Conclusion A single subacromial injection of iPRF produces durable, progressive improvement in pain and shoulder function in patients with PTRCTs, outperforming corticosteroid injection at midterm and long-term follow-up. The use of iPRF offers a safe, autologous, regenerative alternative to corticosteroids.