SynthesisJournal of orthopaedic surgery and research2025
The evolving efficacy landscape of intra-articular injections for rotator cuff injuries over time: a network meta-analysis of randomized controlled studies.
Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRotator cuff injury (RCI), a leading cause of shoulder disability, necessitates effective non-surgical interventions. Despite widespread use of intra-articular injections (corticosteroids, hyaluronic acid [HA], prolotherapy, platelet-rich plasma [PRP]), comparative efficacy across short-, mid-, and long-term outcomes remains unclear due to heterogeneous evidence. PURPOSE: To systematically review the literature to compare corticosteroids, hyaluronic acid, prolotherapy, and platelet-rich plasma for rotator cuff injuries, using network meta-analysis stratified by short-, mid-, and long-term outcomes.
methodsA comprehensive search was conducted across PubMed, Embase, Cochrane Library, Web of Science, Scopus, CNKI, VIPC, and Wanfang Data up to May 2025. Pain (VAS) and functional outcomes (e.g., Constant-Murley Score) were assessed at short- (≤ 1 month), mid- (1-3 months), and long-term (> 3 months) intervals. Frequentist models with random effects ranked interventions via SUCRA.
resultsTwenty-nine RCTs (1800 patients) were included. For pain relief, prolotherapy consistently ranked highest across all timeframes. PRP also exhibited favorable long-term analgesic efficacy. Corticosteroids showed short-term benefits but inferior long-term efficacy. For functional improvement, HA demonstrated the best short-term results, whereas prolotherapy was optimal for mid-term recovery. Long-term functional outcomes favored HA and prolotherapy. The detailed SUCRA values and rankings for all interventions and timepoints are presented in Table 2.
conclusionsComparative efficacy analysis suggests temporal variations in treatment outcomes: prolotherapy and HA offer the most favorable early (≤ 3 months) symptom control for both pain and function. For sustained pain relief (> 3 months), prolotherapy and PRP rank highest, while HA and prolotherapy are associated with better long-term functional outcomes. Corticosteroids appear most effective for short-term analgesia, with diminishing efficacy over longer durations. This evidence supports a shift from using a single injection agent towards a tailored strategy that selects different injections based on the patient's symptoms and the specific treatment phase to achieve optimal outcomes. PROSPERO registration: PROSPERO registration number: CRD42025632416. LEVEL OF EVIDENCE: Level I Systematic Review and MetaAnalysis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.