Abstract：
OBJECTIVE: Platelet-rich plasma (PRP) and corticosteroids are used to treat rotator cuff diseases. However, few reviews have compared the effects of these 2 treatments. In this study, we compared the effects of PRP and corticosteroid injection on the prognosis of rotator cuff diseases.
METHODS: According to the Cochrane Manual of Systematic Review of Interventions, the PubMed, Embase, and Cochrane databases were searched comprehensively. Two independent authors screened suitable studies and performed data extraction and risk of bias assessment. Only randomized controlled trials comparing the effects of PRP and corticosteroid in the treatment of rotator cuff injuries were included, as measured by clinical function and pain during different follow-up periods.
RESULTS: Nine studies with 469 patients were included in this review. In short-term treatment, corticosteroids were superior to PRP in the improvement of Constant, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores (mean difference [MD] -5.08, 95% confidence interval [CI] -10.26, 0.06; P = .05 and MD -0.97, 95% CI -1.68, -0.07; P = .03 and MD -6.67, 95% CI -12.85, -0.49; P = .03, respectively). No statistically significant difference was observed between the 2 groups at midterm (P > .05), and the recovery of the Simple Shoulder Test and American Shoulder and Elbow Surgeons scores in PRP treatment was significantly better than that in corticosteroid treatment in the long term (MD: 1.21, 95% CI: 0.68, 1.74; P < .00001 and MD: 6.96, 95% CI: 3.90, 9.61; P < .00001, respectively). In pain reduction based on visual analog scale score, corticosteroids led to better pain reduction (MD: 0.84, 95% CI: 0.03, 1.64; P = .04), but no significant difference was observed in pain reduction between the 2 groups in the any term (P > .05). However, these differences did not reach the minimum clinically important difference.
CONCLUSIONS: Current analysis showed that corticosteroids have better efficacy in short term, whereas PRP is more beneficial for long-term recovery. However, no difference was observed in the mid-term efficacy between the 2 groups. Randomized controlled trials with longer follow-up periods and larger sample sizes are also needed to determine the optimal treatment.
METHODS: According to the Cochrane Manual of Systematic Review of Interventions, the PubMed, Embase, and Cochrane databases were searched comprehensively. Two independent authors screened suitable studies and performed data extraction and risk of bias assessment. Only randomized controlled trials comparing the effects of PRP and corticosteroid in the treatment of rotator cuff injuries were included, as measured by clinical function and pain during different follow-up periods.
RESULTS: Nine studies with 469 patients were included in this review. In short-term treatment, corticosteroids were superior to PRP in the improvement of Constant, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores (mean difference [MD] -5.08, 95% confidence interval [CI] -10.26, 0.06; P = .05 and MD -0.97, 95% CI -1.68, -0.07; P = .03 and MD -6.67, 95% CI -12.85, -0.49; P = .03, respectively). No statistically significant difference was observed between the 2 groups at midterm (P > .05), and the recovery of the Simple Shoulder Test and American Shoulder and Elbow Surgeons scores in PRP treatment was significantly better than that in corticosteroid treatment in the long term (MD: 1.21, 95% CI: 0.68, 1.74; P < .00001 and MD: 6.96, 95% CI: 3.90, 9.61; P < .00001, respectively). In pain reduction based on visual analog scale score, corticosteroids led to better pain reduction (MD: 0.84, 95% CI: 0.03, 1.64; P = .04), but no significant difference was observed in pain reduction between the 2 groups in the any term (P > .05). However, these differences did not reach the minimum clinically important difference.
CONCLUSIONS: Current analysis showed that corticosteroids have better efficacy in short term, whereas PRP is more beneficial for long-term recovery. However, no difference was observed in the mid-term efficacy between the 2 groups. Randomized controlled trials with longer follow-up periods and larger sample sizes are also needed to determine the optimal treatment.
摘要：
背景：富血小板血浆（PRP）和皮质类固醇用于治疗肩袖疾病。然而,很少有评论比较这两种治疗方法的效果。在这项研究中,我们比较了PRP和糖皮质激素对肩袖疾病预后的影响。
方法：根据Cochrane干预措施系统评价手册，PubMed,Embase,和Cochrane数据库进行了全面搜索。两名独立作者筛选了合适的研究，并进行了数据提取和偏倚风险评估。仅纳入比较PRP和皮质类固醇治疗肩袖损伤效果的随机对照试验(RCT)。通过不同随访期间的临床功能和疼痛来衡量。
结果：本综述纳入了9项研究，共469例患者。在短期治疗中,皮质类固醇在常数的改善方面优于PRP，SST,和ASES评分（MD-5.08，95CI-10.26，0.06；P=0.05和MD-0.97，95CI-1.68，-0.07；P=0.03和MD-6.67，95CI-12.85，-0.49；P=0.03，分别）。两组中期比较差异无统计学意义(P>0.05)。长期PRP治疗的SST和ASES评分恢复明显优于皮质类固醇治疗（MD1.21，95CI0.68，1.74；P<.00001和MD6.96，95CI3.90，9.61；P<.00001）。在基于VAS评分的疼痛减轻中，皮质类固醇导致更好的疼痛减轻(MD0.84,95CI0.03,1.64;P=.04),但两组在疼痛减轻方面无显著差异(P>.05)。然而,这些差异没有达到最小的临床重要差异.
结论：目前的分析表明，皮质类固醇在短期有较好的疗效，而PRP更有利于长期恢复。然而,两组的中期疗效无差异.还需要具有较长随访时间和较大样本量的RCT来确定最佳治疗。
方法：根据Cochrane干预措施系统评价手册，PubMed,Embase,和Cochrane数据库进行了全面搜索。两名独立作者筛选了合适的研究，并进行了数据提取和偏倚风险评估。仅纳入比较PRP和皮质类固醇治疗肩袖损伤效果的随机对照试验(RCT)。通过不同随访期间的临床功能和疼痛来衡量。
结果：本综述纳入了9项研究，共469例患者。在短期治疗中,皮质类固醇在常数的改善方面优于PRP，SST,和ASES评分（MD-5.08，95CI-10.26，0.06；P=0.05和MD-0.97，95CI-1.68，-0.07；P=0.03和MD-6.67，95CI-12.85，-0.49；P=0.03，分别）。两组中期比较差异无统计学意义(P>0.05)。长期PRP治疗的SST和ASES评分恢复明显优于皮质类固醇治疗（MD1.21，95CI0.68，1.74；P<.00001和MD6.96，95CI3.90，9.61；P<.00001）。在基于VAS评分的疼痛减轻中，皮质类固醇导致更好的疼痛减轻(MD0.84,95CI0.03,1.64;P=.04),但两组在疼痛减轻方面无显著差异(P>.05)。然而,这些差异没有达到最小的临床重要差异.
结论：目前的分析表明，皮质类固醇在短期有较好的疗效，而PRP更有利于长期恢复。然而,两组的中期疗效无差异.还需要具有较长随访时间和较大样本量的RCT来确定最佳治疗。
