Disclosures: Francis P. Lagattuta, MD: No financial relationships or conflicts of interest

Objective: Patients with osteoarthritis, tendinosis, or slight tears of the shoulder have few options for long-term care. Recently, platelet-rich plasma (PRP) and stem cell-based therapies have become available. This study is to review low-leukocyte PRP injections in different structures.

Design: A retrospective study with twenty-three male patients aged 35 to 70 had low-leukocyte PRP injections in 25 shoulders – in the AC joint, glenohumeral joint, supraspinatus tendon, and biceps tendon sheath. The PRP kits were tested showing low to no leukocytes. Patients’ pain relief and duration of pain relief were identified. Setting : Outpatient clinic Participants : 23 male patients

Interventions: PRP injections to the joints and tendons of the shoulder

Main Outcome Measures: Pain relief

Results: Seventeen patients’ shoulders had excellent results – 80 percent to 100 percent relief. Five patients’ shoulders had 50 percent to 70 percent relief. Three patients’ shoulders saw no relief. Nine patients’ shoulders had more than six months of relief and currently are pain-free. Eight patients’ shoulders had relief from three to six months; five had relief from two to three months, and three patients’ shoulders received no relief. Conclusions: PRPs contains higher-than-normal cytokines and growth factors, causing production of new hyaline and/or fibrocartilage. The shoulder has many moving parts, which is different than the knee and elbow. Usually two tubes of blood are drawn, and 10 ml of substrate is available for injection. This allows us to inject multiple structures in one shoulder, something that cannot be done with corticosteroids. And with so much substrate available, asymptomatic structures that have pathology can be injected as well. This allows for more healing growth factors to be available, enhancing the overall health of the shoulder structures. PRP in the shoulder is a very effective treatment for shoulder pain caused by multiple structures in the shoulder, and should be a first-line treatment after physical therapy fails.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/low-leukocyte-prp-injections-in-the-shoulder/