Comparison in Efficacy Of Ultrasound Guided Injections of Dextrose Prolotherapy and Platelet Rich Plasma (PRP) In Rotator Cuff Tendinopathy Based on Clinical Functional and Radiological Assessment

Background: Rotator cuff tendinopathy is a leading cause of shoulder pain, often involving subacromial bursitis, tendinitis, or impingement syndromes. Conventional management frequently fails, prompting interest in alternative therapies like prolotherapy and platelet-rich plasma (PRP) injections. This study aimed to compare the effectiveness of ultrasound-guided dextrose prolotherapy and PRP injections in patients with rotator cuff tendinopathy.

Methods: In a double-blind randomized controlled trial conducted over 18 months at the Department of Anaesthesia, Pain and Critical Care Medicine, S. N. Medical College, Agra, 60 patients aged 40–50 years with ultrasound-confirmed rotator cuff tendinopathy unresponsive to conservative therapy were enrolled. Patients were randomized into two groups: Group 1 received 10 ml of 25% dextrose with lidocaine; Group 2 received 5 ml of PRP. Injections were administered twice, two weeks apart. Pain and function were evaluated using the Visual Analog Scale (VAS) and the Western Ontario Rotator Cuff (WORC) index. Secondary outcomes included range of motion (ROM) and musculoskeletal ultrasound findings.

Results: Baseline characteristics were comparable between groups. Prolotherapy (Group 1) showed significantly greater improvement in WORC scores (p < 0.001), VAS scores, and shoulder ROM (p = 0.003) than PRP (Group 2). Ultrasound imaging post-treatment showed better tendon healing and fewer cases of persistent tendinopathy or bursitis in the prolotherapy group (p < 0.001). Both groups had similar outcomes in resolving bicipital tenosynovitis.

Conclusion: Ultrasound-guided dextrose prolotherapy demonstrated superior efficacy over PRP in managing rotator cuff tendinopathy, offering broader functional and structural improvements.