PRP Treatment vs. Plate Removal: Which Comes First for Shoulder Recovery?

The order of PRP injection and plate removal?

Hello, doctor.
I have a rotator cuff tear caused by a fracture injury and I am considering PRP treatment.
However, there is still a fixation plate on the proximal humerus from the initial injury, which can be removed after a year.
Should I remove the plate first or proceed with PRP treatment? If I have the plate removed, how long should I wait before getting PRP? Thank you.

Maruko, 30~39 year old female. Ask Date: 2021/12/25

Dr. Li Yanheng reply Rehabilitation

If there is a plan to remove the metal plate, it is recommended to administer the injection at least six weeks after the removal.
If there is no plan for removal, the injection can be given directly (removal of the metal plate is not necessarily required).

Reply Date: 2021/12/25

More Info

When considering the treatment options for shoulder recovery after a rotator cuff injury, particularly in the context of having a plate still fixed in place, it is essential to weigh the benefits and timing of both Platelet-Rich Plasma (PRP) therapy and the removal of the fixation plate.
PRP therapy is a regenerative treatment that utilizes the patient’s own blood components to promote healing in injured tissues. It is particularly beneficial in cases of tendon injuries, ligament sprains, and joint pain, as it can enhance the healing process by delivering growth factors directly to the injured area. In your case, since you have a rotator cuff tear and a fixation plate in place, the timing of PRP treatment is crucial.

The general recommendation is to remove the fixation plate before proceeding with PRP therapy. This is because the presence of the plate may interfere with the healing process and the effectiveness of the PRP treatment. Once the plate is removed, it is advisable to wait for a period of at least six weeks before administering PRP. This waiting period allows the surgical site to heal adequately and reduces the risk of complications associated with injecting PRP into a freshly operated area.

After the removal of the plate, the healing process of the shoulder should be monitored closely. If the surgical site is healing well and there are no signs of infection or complications, PRP can then be administered to enhance the recovery of the rotator cuff. The PRP treatment can help to reduce inflammation, promote tissue regeneration, and potentially alleviate pain, which can be particularly beneficial if you are experiencing ongoing discomfort.

It is also essential to engage in a structured rehabilitation program post-surgery and PRP treatment. Physical therapy plays a critical role in restoring range of motion, strength, and function to the shoulder. A physical therapist can guide you through exercises tailored to your specific condition, ensuring that you regain full functionality while minimizing the risk of re-injury.

In summary, for optimal recovery from a rotator cuff injury with a fixation plate, it is advisable to first remove the plate and then wait for about six weeks before considering PRP therapy. This approach allows for a more effective healing process and maximizes the benefits of PRP treatment. Always consult with your orthopedic surgeon or healthcare provider to tailor the treatment plan to your specific needs and circumstances, ensuring the best possible outcome for your shoulder recovery.

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