Platelet Rich Plasma (PRP) is an autologous mixture produced by centrifugation of blood.

Understanding the clinical efficacy of PRP remains a challenge in the field of sports medicine, including the treatment of various shoulder diseases.

According to the American Academy of Orthopedic Surgeons’ Research Symposium Update on the Use of Biologic Pharmaceuticals in Orthopedic Injuries, PRP products are classified based on several factors such as the presence of leukocytes or fibrin in the PRP setting, activation or inactivation of PRP, and/or platelet concentration.

The effectiveness of PRP is still under investigation, including in rotator cuff disease, subacromial impingement syndrome,

adhesive capsulitis of the shoulder,

and degenerative arthritis of the shoulder (OA).

PRP contains an abundance of molecules, each of which exhibits distinct biological effects depending on the type of biological effect of PRP in different tissues.

Most studies examining the effect of PRP on shoulder tissues have focused on growth factors released by platelet granules such as platelet-derived growth factor,

transforming growth factor-β (TGF-β),

vascular endothelial growth factor,

epidermal growth factor,

insulin-like growth factor,

growth factor Fibroblasts.

Research has identified a preference for PRP preparations based on broader indications such as tendinopathy, OA, bone regeneration, or tendon-to-bone healing.

Based on reports, PRP appears to be the preferred treatment option for tendinopathy (eg, lateral epicondylitis, Achilles tendinopathy, patellar tendinopathy, and rotator cuff tendinopathy).

Clinical uses of platelet-rich plasma in shoulder conditions

• Rotator cuff tear and tendinopathy

Most of the clinical literature examining the use of PRP in the shoulder focuses on rotator cuff tears, in both surgical and non-surgical settings. However, the evidence surrounding the effectiveness of PRP in treating rotator cuff disease remains uncertain. Still, more research is needed in this area to better answer whether or not this method can be useful in rotator cuff disease.

In the USA, it was found that platelet-rich plasma (PRP) improved the outcome of shoulder and elbow surgery in patients with rotator cuff tendinopathy in the absence of a rotator cuff tear for 3 months compared to conservative treatment with exercise.

• degenerative inflammation of the shoulder joint

PRP has also been studied in the humeral OA area in conservative treatment and as an adjunct to intraoperative shoulder joint repair. 81% of patients were satisfied with their results, and radiographic results were favorable.

The use of PRP in the treatment of musculoskeletal disorders has been increasing over time, and its use in the shoulder joint is second only to its use in the knee.

What is clear is that additional evidence is needed about the use of PRP in the treatment of shoulder diseases. There is a need to standardize preparation protocols to compare studies appropriately. The differences in their effectiveness may be due to different preparation methods and injection techniques for PRP.

We can conclude that it is beneficial and that platelet-rich plasma shows an improvement in joint vital functions compared to treatment without it.