Authors' objectives: To determine whether there is any evidence on the efficacy/effectiveness of prolotherapy in treating rotator cuff tendinopathy.

Authors' results and conclusions: Seven hundred ninety-three published studies were identified through the search. After duplicates were removed, 632 published studies were identified through the search. Upon examination of the titles and abstracts of these published studies, there were 57 studies thought to be relevant to prolotherapy use in treating rotator cuff tendinopathy, 143 were excluded due to incorrect population, 281 due to incorrect interventions, 88 due to incorrect study design, and 63 were animal/cell culture studies. Of the 57 studies that were retrieved in full, four were excluded due to incorrect population, two were excluded due to incorrect intervention, one was excluded due to incorrect outcomes, 22 were excluded due to incorrect study design, and six were ongoing trials. Nine systematic reviews on rotator cuff tendinopathy were identified. A manual search of the references from the studies selected for full text screening revealed two additional studies. Therefore, there are fifteen new published studies that are relevant to this systematic review. Overall, study quality was medium-low: three studies showed medium-high quality, five studies showed moderate quality, while the other seven had low study quality. Study quality was downgraded to low due to lower levels of evidence, methodological limitations and imprecision. There is some moderate-low quality evidence pointing toward the efficacy of prolotherapy for treating rotator cuff tendinopathy, particularly compared to minimal or no treatment. However, there were some clear temporal trends that influenced the effect prolotherapy had on pain outcomes. Overall, there is some moderate-low evidence, pointing towards the use of prolotherapy in treating rotator cuff tendinopathy patients, particularly compared to minimal or no treatment. However, due to the comparable results in pain and functional outcomes from the use of other active treatments, the lack of high quality, long-term studies, and heterogeneity of treatment protocols, this evidence should be interpreted with caution. Therefore, there is still no conclusive evidence reporting on the efficacy of prolotherapy in the treatment of rotator cuff tendinopathy.

Authors' methods: A systematic literature search was started on March 6, 2024. This literature search was conducted on commercial medical literature databases. The search was done by employing a combination of keywords. Only comparative studies were considered; no other limitations were implemented in any of these searches. A manual search was also planned and conducted on the references of the articles that were retrieved in full.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/effectiveness-prolotherapy-rotator-cuff-tendinopathy?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DEffectiveness%2520of%2520Prolotherapy%2520in%2520Rotator%2520Cuff%2520Tendinopathy%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Effectiveness%20of%20Prolotherapy%20in%20Rotator%20Cuff%20Tendinopathy

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC