Objectives:The survey conducted at the 2024 biennial meeting of the Iranian Society of Knee Surgery, Arthroscopy, and Sports Traumatology (ISKAST) aimed to assess practice trends among ISKAST members in primary total knee arthroplasty (TKA), thereby providing a benchmark for future studies. Methods:The session moderator presented multiple-choice questions via an audience response system to 94 registered ISKAST members. Responses were collected centrally and subsequently displayed to the audience after a brief interval. Results:The survey revealed that most ISKAST surgeons, reflecting their high level of expertise, work in diverse settings, with more than half performing over 100 TKAs annually. Regarding perioperative management, the majority of respondents utilize spinal anesthesia and tranexamic acid, with a significant number applying tourniquets during surgery. The median parapatellar approach and posterior cruciate-substituting designs are commonly preferred for routine TKA procedures. Additionally, pain management is primarily achieved through patient-controlled analgesia, while low-molecular-weight heparin, combined with mechanical measures, is the most common method for venous thromboembolism prophylaxis. Although follow-up practices vary, the majority of surgeons schedule annual postoperative visits. Conclusion:The survey results provide valuable insights into the approaches of knee surgeons in Iran toward TKA, highlighting both common practices and variations in treatment methods. While these findings reflect current practices, they may not represent the most optimal techniques. This underscores the need for further research to validate these results and explore their applicability to a broader patient population.

Background: Posterior cruciate ligament (PCL) injury is a relatively common musculoskeletal condition. However, there is currently a lack of consensus on decision-making, treatment and postoperative management for such injuries. Objectives: To use the modified Delphi method to reach expert consensus on the management of PCL injury. Methods: A literature search of PubMed, Cochrane Library, Embase, and Web of Science for articles up to 17 October 2024, to support the development of recommendation statements. An Expert Panel of 90 experienced clinicians from orthopaedics and sports medicine participated in a two-round Delphi process. Each statement was evaluated in two parts: the first part assessed content appropriateness (score of 7-9 indicating appropriateness and 4-6 indicating possible appropriateness), while the second part assessed agreement (score of 5-9 indicating agreement). Results: The panel members developed 11 statements using the Delphi process, addressing the following topics: (1) clinical decision-making, (2) treatment, and (3) postoperative management about PCL injuries. The final consensus was reached on 11 statements and we eventually translated these statements into a corresponding table of expert recommendations. Conclusion: Consensus was reached on 11 statements regarding three aspects of PCL injury management. These findings provide a foundation for developing evidence-based guidelines that can enhance clinical decision-making, improve treatment strategies, and optimize postoperative care for patients with PCL injuries.

BACKGROUND:Posterior cruciate ligament (PCL) injury is a relatively common musculoskeletal condition. However, there is currently a lack of consensus on decision-making, treatment and postoperative management for such injuries. OBJECTIVES:To use the modified Delphi method to reach expert consensus on the management of PCL injury. METHODS:A literature search of PubMed, Cochrane Library, Embase, and Web of Science for articles up to 17 October 2024, to support the development of recommendation statements. An Expert Panel of 90 experienced clinicians from orthopedics and sports medicine participated in a two-round Delphi process. Each statement was evaluated in two parts: the first part assessed content appropriateness (score of 7-9 indicating appropriateness and 4-6 indicating possible appropriateness), while the second part assessed agreement (score of 5-9 indicating agreement). RESULTS:The panel members developed 11 statements using the Delphi process, addressing the following topics: (1) clinical decision-making, (2) treatment, and (3) postoperative management about PCL injuries. The final consensus was reached on 11 statements and we eventually translated these statements into a corresponding table of expert recommendations. CONCLUSION:Consensus was reached on 11 statements regarding three aspects of PCL injury management. These findings provide a foundation for developing evidence-based guidelines that can enhance clinical decision-making, improve treatment strategies, and optimize postoperative care for patients with PCL injuries.

Do Functional Outcomes Differ Among Total Knee Arthroplasty Approaches at six, 12, and Beyond 18 Months of follow-up? Response/Recommendation: Current literature indicates no clinically relevant or statistical differences in early functional outcomes (within 6 months post-surgery) when comparing various surgical approaches to the medial parapatellar approach. However, in more extended follow-up (beyond 18 months), both the quadriceps-sparing and mid-vastus approaches showed clinically relevant and statistically significant improvements in functional outcomes compared to the medial parapatellar approach, with the mid-vastus approach exhibiting superior results at beyond 18 months of follow-up. Level of Evidence: high Expert Vote: Agree 57.2%, Disagree 32.8%, and Abstain 9.8%.

BACKGROUND:Chronic ankle instability (CAI) commonly follows ankle sprains and significantly affects walking patterns and daily activities. Two main surgical treatments exist: Broström repair and anatomic allograft reconstruction. It remains unclear which technique better restores normal ankle movement. This study compared how these 2 surgeries affect ankle function during walking. METHODS:We conducted a prospective study with 30 CAI patients. Fifteen received Broström repair and 15 received anatomic allograft reconstruction. We also included 16 healthy controls. We analyzed ankle joint kinematics (range of motion in dorsi/plantar flexion and inversion/eversion), and kinetics (joint moments, power, and ground reaction force [GRF]) during the gait cycle using 3D motion capture and force plate measurements. Assessments were performed before and 8 months after surgery. RESULTS:Both surgical techniques altered ankle biomechanics compared with controls. However, the Broström repair group demonstrated gait patterns more similar to healthy controls in most parameters. The reconstruction group showed greater deviation from normal, with increased plantarflexion and eversion throughout the gait cycle. Kinetic analysis revealed that Broström repair better preserved normal ankle moment patterns, while reconstruction resulted in significant alterations in ankle power generation. CONCLUSION:Both surgical techniques alter ankle mechanics, but Broström repair more effectively restores normal ankle biomechanics compared with allograft reconstruction in CAI patients during walking. These findings can guide surgeons in selecting the most appropriate surgical technique for restoring natural gait patterns. LEVEL OF EVIDENCE:II.

Sports-related anterior cruciate ligament (ACL) ruptures are linked to abnormal muscle activation patterns, extending treatment and delaying athletes’ return to sports (RTS) post-ACL reconstruction (ACLR). Given its prevalence among athletes, accurately estimating safe RTS time is crucial. This study introduces a deep convolutional neural network (DCNN) designed to classify ACL health levels in injured athletes, aiding in RTS estimation. Ten ACLR athletes and fourteen healthy controls participated. We defined three ACL health levels: healthy, six months post-ACLR, and nine months post-ACLR. Surface electromyography (sEMG) signals were recorded from five knee muscles during single-leg drop landing (SLDL) and single-leg forward hopping (SLFH) tasks. The time-frequency Pseudo-Wigner-Ville distribution (PWVD) calculated energy distribution patterns of non-stationary sEMG signals, generating heatmap images. The PWVD, preferred for its superior time-frequency localization over wavelet transform, processed these heatmaps, which were then analyzed by the custom-designed DCNN. The DCNN classifier achieved a 90% accuracy in categorizing ACL health levels. Additionally, it calculated the probability of data points belonging to specific classes, estimating safe RTS time for athletes. This study demonstrates the potential of DCNN classification using sEMG signals to estimate RTS time, providing valuable insights into ACLR recovery in athletes.

Combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injury is the most common combination of ligamentous knee injury. Many authors support the conservative treatment of MCL tears. This study aimed to compare the outcomes of simultaneous ACL reconstruction (ACL-R) and MCL reconstruction with ACL-R and conservative MCL treatment in cases of combined ACL and grade III MCL injuries. In this retrospective cohort study, we evaluated consecutive patients with combined ACL and MCL injuries who underwent surgical treatment over five years in two private hospitals in Tehran, Iran. We compared postoperative knee range of motion (ROM), pain intensity (visual analog scale [VAS]), functional outcomes (Tegner-Lysholm and International Knee Documentation Committee Subjective Knee Form [IKDC] scores), time to and proportion of return to sports, time to return to work, activity level (Marx activity rating scale), and graft failure rate between ACL-R and conservative MCL treatment (ACL-R + conservative MCL group) and ACL-R and MCL reconstruction (ACL-R + MCL-R group). All patients were followed for at least twelve months. Overall, 110 patients, comprising 92 men (83.6

Background: Lower-extremity fractures (LEFs) account for >30% of all skeletal injuries, contributing to the global health and economic burden. Fracture epidemiology in the Middle East and North Africa (MENA) region has been studied little. Health factors and disease epidemiology differ greatly among populations in MENA despite cultural, political, and economic similarities among the region’s countries. This study examined the epidemiology of LEFs and the need for rehabilitation in MENA from 1990 to 2019. Methods: We examined the epidemiology of fractures of the pelvis, hip, femur, patella, tibia, fibula, ankle, and foot bones using Global Burden of Disease (GBD) data. Fracture incidence, counts, and rates were measured for males and females across age groups in the 21 MENA countries as identified by the GBD data set. Associations between years of healthy life lost due to disability (YLD) resulting from fracture and the Socio-demographic Index (SDI) were analyzed. Results: In contrast to the global trend, the age-standardized incidence rate (ASIR) of LEFs in the MENA region increased by 4.57% from 1990 to 2019. In 2019, the highest ASIR among fractures was attributed to fractures of the patella, fibula, tibia, or ankle (434.36 per 100,000), most frequently occurring among those 20 to 24 years of age. In 2019, the highest ASIR of all fractures was noted in Saudi Arabia (2,010.56 per 100,000) and the lowest, in Sudan (523.29 per 100,000). The greatest increases from 1990 to 2019 in the ASIR of LEFs were noted in Yemen (132.39%), Syria (107.27%), and Afghanistan (94.47%), while the largest decreases were found in Kuwait (−62.72%), Sudan (−48.72%), and Iran (−45.37%). In 2019, the YLD rate of LEFs had increased to 277.65 per 100,000, up from 235.55 per 100,000 in 1990. Conclusions: Between 1990 and 2019, LEFs increased in the MENA region. Violence, war, and road traffic accidents increased, leading to a high rate of fractures, especially among youth. Low bone-mineral density related to vitamin D deficiency has also been reported as a risk factor for fracture in the region. Regional health authorities should be informed of fracture patterns by this study. Level of Evidence: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

BACKGROUND:Short-keeled tibial implants may be at higher risk of aseptic loosening. Stem augmentation has been suggested to improve its fixation. We aimed to assess whether this technique could decrease the loosening rate of such tibial implants. METHODS:We retrospectively studied the knees receiving stemmed versus nonstemmed versions of a short-keeled prosthesis. A total of 932 patients undergoing total knee arthroplasty using a Persona prosthesis with >24-month follow-up (mean 53.7) were included, of whom 212 were at high risk of loosening due to osteoporosis or high body mass index (BMI). The rate of tibial aseptic loosening in high-risk patients and in the whole cohort was compared between those with and without stem extension. Multivariable analysis was conducted to identify the risk factors of loosening. RESULTS:In the whole cohort, in 203 knees (21.8%), a cemented short stem was used, versus 729 knees (78.2%) without. The tibial implant revision rates for loosening were 2.06% and 0.99% for nonstemmed and stemmed cases, respectively ( P = 0.551). When the cohort was categorized based on the loosening risk factors, the loosening risk was significantly higher in the high-risk than in the low-risk group, regardless of stem status (log-rank test = 8.1, hazard ratio = 2.17, 95% CI = 1.78, 2.57, P = 0.005). 212 patients were at high risk of loosening, due to high BMI or osteoporosis, among whom the risk of aseptic loosening was higher when a stem was not used (log-rank = 32.1, hazard ratio = 4.95, 95% CI = 4.05, 5.86, P < 0.001). In multivariate analysis, osteoporosis, BMI ≥35, and smoking were correlated with loosening. CONCLUSION:The failure rate was markedly lower in the stemmed group of the patients at elevated risk of aseptic loosening due to osteoporosis and/or high BMI. In the entire cohort, the risk of loosening in stemmed tibial implants was similar to the nonstemmed group. The findings support a protective role for the stem in patients at high risk of failure of the cemented tibial implant. LEVEL OF EVIDENCE:III therapeutic.

The anterior cruciate ligament (ACL) is a common knee injury in high-intensity sports, which can cause early career loss in young athletes. Concomitant damage to other knee stabilizers may occur, such as the medial collateral ligament (MCL). Recent studies have shown that knee stability can increase without surgical intervention in patients with ACL and MCL injuries. Regarding the importance of functional tests in return to exercise prediction, this study aims to measure nonsurgical approach's long-term outcome for concomitant ACL and MCL injuries with a focus on functional tests. This is a case-control study with a 2-year follow-up. The case group consisted of patients who had provided written consent and completed their 2-year follow-up, and the control group was made up of healthy people who did not have any knee medical conditions and were matched by age, gender, and activity level. Physical examinations, Tegner and International Knee Documentation Committee questionnaires, and knee magnetic resonance imaging were conducted, and functional performance tests were performed after a 10-minute warm-up. Lody's index (the ratio of injured-to-uninjured knee results) was calculated. The data were analyzed using independent t-test, one-way analysis of variance, chi-squared test, and Fisher's exact test. The study involved 11 patients in each concomitant ACL and MCL injury cases and healthy control groups with a mean age of 32.4 and 28 years, respectively. None of the patients reported knee instability symptoms in the 2-year follow-up. More than half of the patients continued their sports field without reinjury, with no significant difference in activity levels between case and control groups. The 6-meter hop test and single-leg hop test showed no significant difference between case and control groups (p-value: 0.326, 0.859), and no significant difference was observed in the three Carioca, cocontraction, and Shuttle tests in the 2-year follow-up. Functional tests in ACL and MCL injuries revealed normal outcomes, implying a nonsurgical approach for patients with proximal ACL tears, better knee stability, and no significant differences between the injured and control groups.

Purpose A personalized model of the knee joint, with adjustable effective geometric parameters for the transplanted autograft diameter in Anterior Cruciate Ligament Reconstruction (ACLR) using the bone-patella-tendon-bone (BPTB) technique, has been developed. The model will assist researchers in understanding how different graft sizes impact a patient’s recovery over time. Methods The study involved selecting a group of individuals without knee injuries and one patient who had undergone knee surgery. Gait analysis was conducted on the control group and the patient at various time points. A 3D model of the knee joint was created using medical images of the patient. Forces and torques obtained from the gait analysis were applied to the model to perform finite element analysis. Results The results of the finite element (FE) analysis, along with kinetic data from both groups, indicate that models with diameters of 7.5 mm and 12 mm improved joint motion during follow-up after ACLR. Additionally, a comparison of the stress applied to the ACL model revealed that a 12 mm autograft diameter showed a more favorable trend in patient recovery during the three follow-up intervals after ACL reconstruction surgery. Conclusion The development of a personalized parametric model with adjustable geometric parameters in ACLR, such as the transplanted autograft diameter, as presented in this study, along with FE using the patient’s kinetic data, allows for the examination and selection of an appropriate autograft diameter for Patella Tendon grafting. This can help reduce stress on the autograft and prevent damage to other knee joint tissues after ACLR.

The anterior cruciate ligament plays a crucial role in maintaining stability within the knee joint, particularly for athletes who frequently experience its rupture. This study presents a novel approach using personalized three-dimensional (3D) parametric finite element modeling of the knee joint to simulate the treatment following anterior cruciate ligament reconstruction (ACLR) in both forward walking (FW) and drop landing (DL) tasks. The study encompasses two distinct cohorts: five healthy athletes and five ACLR patients. Biomechanical motion analysis was conducted on both cohorts, with the ACLR patient group evaluated at 6 and 9 months post-surgery. A comprehensive 3D parametric model of the knee joint was meticulously crafted. The findings reveal a notable reduction in stress on crucial knee structures such as the autograft, meniscus, and cartilages over time for both FW and DL tasks following ACLR, with a reduction in tissue tension of approximately 9.5% and 37% for FW and DL, respectively. This personalized model not only facilitates the investigation of knee joint tissue biomechanics post-ACLR but also aids in estimating the return-to-sports timeline for patients. By accommodating individual tissue geometries and incorporating patient-specific kinetic data, this model enhances our comprehension of post-ACLR biomechanics across various functional tasks, thereby optimizing rehabilitation strategies.

Objectives: This study aimed to introduce aAnew arthroscopic method for reconstructing the popliteus tendon (PT). This minimally invasive technique is performed through the posterolateral corner (PLC) of the knee, which can reconstruct the posterolateral rotary instability (PLRI) of the knee. Methods: Thirty-nine patients (8 females, 31 males) with PLC injury and normal knee alignment underwent arthroscopic PT reconstruction. Among them, 27 patients had combined ACL and PLC injuries, and 9 had been involved in PCL and PLRI. In 3 of them, injuries involved ACL, PCL, and PLC. Physical examination, imaging, and arthroscopic evaluation were performed to assess instability stages. In grade I instability, when the PT had not been injured, the patient was treated with the modified Larson technique and semitendinosus autograft. With grade II injury involving the PT component, arthroscopic reconstruction of the PT was the preferred technique. In grade III injuries, arthroscopic PT reconstruction and the modified Larson technique were used concurrently. Results: All patients were followed up for 58 +/- 1 months postoperatively. Varus and external rotation instability were restored with arthroscopic PLC reconstruction. All patients gained near-normal knee stability and significant improvement with pain, along with improved ability to carry out daily activities. InAcases of varus instability, a considerable improvement was observed in external rotation and reverse pivot shift. There were no cases of arthrofibrosis or limitations in knee motion. Conclusion: Arthroscopic reconstruction of the PT, using our protocol for PLC reconstruction of the knee (with midterm follow-up), showed encouraging results while minimizing surgical morbidity. Level of evidence: IV

Objectives: This study aimed to introduce a novel arthroscopic treatment for medial and posteromedial instability of the knee and present the primary and follow-up results. Methods: All patients who underwent the arthroscopic approach to treat medial and posteromedial corner instability from 2007 to 2017 were included in this report. Overall, 45 patients were included, among which 75.6% were male. The mean age of patients was 32.2 +/- 8.4 years. Overall, 44.4% and 15.6% of patients had associated meniscal injuries and chondral lesions, respectively. The mean follow-up duration of patients was 84.2 +/- 25.3 months. Results: Overall, 37 patients developed a full range of motion (82.2%), and most patients (95.6%) showed excellent quadriceps strength (grades 4 and 5). All patients had a normal or 1+ posterior drawer test, Pivot shift test, and Lachman test on physical examination. Moreover, 60% had an associated isolated anterior cruciate ligament injury, 17.8% had an isolated posterior collateral ligament injury, and 17.6% had a combination of more than one ligament injury. One patient developed septic arthritis. Two patients experienced pain, and one pain patient developed pain with a bony spur formation in the medial epicondyle. Three patients showed a 2+ medial collateral ligament (MCL) test (moderate instability) at the final follow-up, all of whom had multi -ligament injuries. All patients, except the three patients who had a failed MCL reconstruction, returned to their previous activities. Conclusion: This study described a novel arthroscopic treatment of MCL injury, and the results showed acceptable postoperative and clinical outcomes. As the use of minimally invasive surgery may minimize multiple complications associated with open surgery, it is suggested that further studies be conducted regarding this approach when faced with patients who have MCL injuries requiring surgery.

The association between injuries to the anterior cruciate ligament, medial collateral ligament, and medial meniscus (MM) has been known to orthopedic surgeons since 1936; O'Donoghue first used the term "unhappy triad" of the knee to describe this condition in 1950. Later studies revealed that involvement of the lateral meniscus is more common than MM in these cases, leading to a change in the definition. Recent studies have revealed that this triad may be primarily linked to knee anterolateral complex injuries. Although there is not a definite management protocol for this triad, we try to mention the most recent concepts about it in addition to expert opinions.

Background:Burnout is a well-known consequence of chronic stress. Orthopedic surgery is among the most desired specialty among Iranian medical students. The nature of the job, the income, and the ability to deal with stress can all be stressful factors for orthopedic surgeons. Nonetheless, little is known about how these medical doctors work and live in Iran. The present study aimed to assess job satisfaction, engagement, and burnout among Iranian orthopedists.Methods:A nationwide online survey was conducted in Iran. Job satisfaction, engagement, and burnout were evaluated using the job description index (JDI), Utrecht Work Engagement Scale, and Maslach Burnout Scale. They were also asked some additional questions related to career choice.Results:A total of 456 questionnaires (41% response rate) were retrieved. Overall, 56.8% of the participants experienced burnout. The burnout levels significantly differed based on age, years from graduation, working in public hospitals, operating more than 10 patients in a week, monthly income, having less than two children, and being single (P<0.05). They scored higher on work questions on the present job and jobs in general but lower scores on pay and opportunities for promotion.Conclusion:In a national study of orthopedic surgeons, their primary concern in JDI was "pay and promotion." Burnout was substantially associated with respondents' characteristics, such as younger age and having fewer children. This will lead to impaired performance, increased patient complaints, and the tendency to immigrate.

BACKGROUND:The medial patellofemoral ligament (MPFL), along with the medial patellotibial ligament (MPTL) and medial patellomeniscal ligament, aid in the stabilization of the patellofemoral joint. Although the MPFL is the primary stabilizer and the MPTL is a secondary limiter, this ligament is critical in maintaining joint stability. There have been few studies on the combined MPFL and MPTL reconstruction and its benefits. AIM:To look into the outcomes of combined MPFL and MPTL reconstruction in frequent patellar instability. METHODS:By May 8, 2022, four electronic databases were searched: Medline (PubMed), Scopus, Web of Science, and Google Scholar. General keywords such as "patellar instability," "patellar dislocation," "MPFL," "medial patellofemoral ligament," "MPTL," and "medial patellotibial ligament" were co-searched to increase the sensitivity of the search. RESULTS:The pooled effects of combined MPFL and MPTL reconstruction for Kujala score (12-mo follow-up) and Kujala score (24-mo follow-up) were positive and incremental, according to the findings of this meta-analysis. The mean difference between the Cincinnati scores was also positive, but not statistically significant. The combination of the two surgeries reduces pain. According to cumulative meta-analysis, the trend of pain reduction in various studies is declining over time. CONCLUSION:The combined MPFL and MPTL reconstruction has good clinical results in knee function and, in addition to providing good control to maintain patellofemoral joint balance, the patient's pain level decreases over time, making it a valid surgical method for patella stabilization.

Abstract Objective To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle. Methods In this case‐control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo‐reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle‐toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion‐eversion at initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing phase of the gait were measured. Results In patients with CAI, the injured and uninjured ankles were significantly different regarding angle‐toe angle, inversion‐eversion RoM, dorsiplantar flexion in mid‐stance, inversion‐eversion at initial contact and terminal stance as well as the pre‐swing and swing phases (p < 0.01). The uninjured ankles of patients showed lower ankle‐toe velocity (p = 0.01) and acceleration (p = 0.01) compared to both the left and right ankles of the controls. In addition, the uninjured ankles of the patients showed decreased ankle dorsiflexion and increased inversion during initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing compared to the control group (p < 0.017). Conclusion The results suggest that unilateral CAI can affect gait biomechanics in the contralateral uninjured ankle. Left unaddressed, unilateral CAI may lead to increased morbidity to the contralateral uninjured side. When surgery is not preferred for the management of unilateral CAI, rehabilitation protocols should focus on both sides.

Abstract Background Studies evaluating the role of both corticosteroids and platelet-rich plasma (PRP) in the treatment of rotator cuff (RC) tendinopathies have been contradicting. We compared structural and clinical changes in RC muscles after corticosteroids and PRP injections. Methods This is a randomized double-blind clinical trial. All individuals with diagnosis of RC tendinitis during 2014–2017 were considered. Individuals were randomly allocated to either receive PRP or corticosteroids. Overall, 3cc of PRP was injected within the subacromial joint and another 3cc was injected at the site of the tendon tear, under the guide of sonography. For the corticosteroid group, 1cc of Depo-medrol 40mg and 1cc of lidocaine (2%) was injected within the subacromial joint. Results Overall, 58 patients entered the study. Comparison of pain, range of motion (ROM), Western Ontario RC (WORC), Disability of Arm-Hand-Shoulder (DASH) scores, and supraspinatus thickness showed significant improvement during follow-ups in both groups (p<0.05). During 3 months of follow-up, pain improvement was significantly better within the PRP group during (from 6.66±2.26 to 3.08±2.14 and 5.53±1.80 to 3.88±1.99, respectively; p=0.023). Regarding ROM, the PRP group had significant improvement in adduction (20.50°±8.23° to 28°±3.61° and 23.21°±7.09° to 28.46°±4.18° for the PRP and corticosteroid groups, respectively; p=0.011) and external rotation (59.66°±23.81° to 76.66°±18.30° and 57.14°±24.69° to 65.57°±26.39°, for the PRP and corticosteroid groups, respectively; p=0.036) compared to the corticosteroid group. Conclusion We found that PRP renders similar results to that of corticosteroids in most clinical aspects among patients with RC tendinopathies; however, pain and ROM may show more significant improvement with the use of PRP. Considering that the use of corticosteroids may be contraindicated in some patients and may be associated with the risk of tendon rupture, we suggest the use of PRP in place of corticosteroid-based injections among patients with RC tendinopathy. Trial registration Clinical trial registration code: IRCT201302174251N9