Platelet-Rich Plasma for Rotator Cuff Tendinitis

Guideline Recommendations

The American Academy of Orthopaedic Surgeons recommends against the routine use of platelet-rich plasma (PRP) for rotator cuff tendinopathy, with a limited strength recommendation, indicating that practitioners should exercise clinical judgment and consider patient preference, in patients with rotator cuff tendinopathy 1, 2, 3
The American Academy of Orthopaedic Surgeons provides a limited strength recommendation against routine PRP use for rotator cuff tendinopathy, meaning practitioners should be alert for emerging evidence, with patient preference playing a substantial role 1, 2, 3

First-line treatment for rotator cuff tendinopathy should be exercise programs and/or NSAIDs, with a moderate strength recommendation, as they show significant improvements in pain and functional scores after 3 months, in patients with rotator cuff tendinopathy 1, 4
A single corticosteroid injection with local anesthetic provides short-term improvement in pain and function, with moderate evidence, in patients with rotator cuff tendinopathy who have not responded to first-line treatment 1, 2, 3, 4

Strong evidence does not support biological augmentation with platelet-derived products for improving patient-reported outcomes in patients with full-thickness rotator cuff tears undergoing surgical repair 1, 2, 3
Limited evidence suggests liquid PRP may decrease retear rates after surgical repair, in patients with full-thickness rotator cuff tears 1, 2, 3

For rotator cuff tendinopathy without full-thickness tear, start with exercise programs + NSAIDs for 3 months, then consider a single corticosteroid injection if there is an inadequate response, and finally consider PRP only after informed discussion about limited evidence, in patients with rotator cuff tendinopathy 1, 2, 3, 4