Can PRP Injections Heal Torn Tendons? What the Research Shows
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By Dr. Jeffrey Peng, MD · Published March 4, 2026 · 8 min read
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For decades, surgery was considered the only reliable option for repairing torn tendons. Partial tears of the rotator cuff, in particular, present a clinical challenge because they rarely heal on their own and tend to worsen over time. However, emerging research suggests that platelet-rich plasma (PRP) injections may offer a compelling nonsurgical alternative — one that not only reduces pain and symptoms but may actually facilitate the complete healing of torn tendon tissue.
In this article, I review two recent clinical studies that demonstrate PRP's potential to heal partial tendon tears of the rotator cuff, with outcomes that rival surgical repair. I also discuss a third study that provides important context about the limitations and protective benefits of PRP in patients with rotator cuff disease.
Why Do Partial Rotator Cuff Tears Get Worse Over Time?
Rotator cuff disease is progressive by nature. It typically begins with biomechanical issues that lead to shoulder impingement and altered mechanics. Over time, this contributes to greater wear and tear on the rotator cuff, resulting in a condition known as tendinopathy. If left untreated, tendinopathy can develop into a partial tear, and partial tears can eventually progress to full-thickness tears, potentially leading to significant shoulder arthritis.
Observational data from Keener et al. (2015) confirmed this troubling trajectory: the majority of degenerative rotator cuff tears enlarge over time, with over half of the tears in their cohort showing significant size increases during a six-year follow-up period. This natural progression is what makes effective early intervention so important.
Can PRP Combined with Barbotage Heal a Partial Rotator Cuff Tear?
A landmark randomized controlled trial by de Castro et al. (2023) investigated whether ultrasound-guided tendon debridement (barbotage) combined with PRP could heal partial tears of the supraspinatus tendon. Patients were randomly assigned to receive either barbotage with leukocyte-poor PRP or barbotage with a saline placebo.
The results were remarkable. At the six-month mark, 87% of the PRP-treated group experienced a measurable reduction in tear size, and 79% achieved complete healing. In contrast, the saline placebo group showed only 32% of tears decreasing in size, with just 21% reaching full healing.
Both groups showed clinical improvements at six weeks compared to baseline. However, only the PRP group continued to improve between the six-week and six-month evaluations, while the placebo group's progress plateaued. The study used a leukocyte-poor PRP formulation at a high concentration of approximately 3 to 4 billion platelets per sample, delivered via fenestration of the tendon without intralesional injection. No side effects or complications were reported beyond mild discomfort in the first 48 hours.
Is PRP as Effective as Surgery for Partial Rotator Cuff Tears?
A second study by Poff et al. (2023) compared the outcomes of PRP injections to arthroscopic surgical repair in patients with MRI-confirmed high-grade intrasubstance partial-thickness rotator cuff tears that had failed traditional conservative treatment.
The PRP group achieved a 96% success rate, with only one patient ultimately requiring surgery. Both groups showed similar improvements in shoulder function scores at the two-year follow-up. The mean ASES score for the PRP group improved from 53.2 at baseline to 95.3 at two years, while the surgical group improved from 52.0 to 96.5.
Critically, the PRP group experienced significantly faster recovery times: the average return to pain-free, unrestricted activity was 3.3 months for PRP compared to 4.6 months for surgery. Additionally, the PRP group had no complications, whereas two patients in the surgical group developed frozen shoulders.
Does PRP Protect Against Tear Progression?
A prospective cohort study by Rossi et al. (2023) provides valuable complementary data. In this study, 150 patients received subacromial leukocyte-rich PRP injections for rotator cuff tendinopathy or partial tears. Overall, 85% of patients achieved clinically meaningful improvement in rotator cuff functional scores.
Notably, no patient with isolated tendinopathy progressed to a partial tear, and no partial tear progressed to a complete tear during the follow-up period. While no partial tears in this study fully healed — likely because the injection was placed in the subacromial space rather than at the tear site using barbotage — the data suggest that PRP is protective against disease progression. This is particularly meaningful given that observational studies consistently show tendinopathy progressing to partial tears and partial tears progressing to full-thickness tears without intervention.
What Do These Findings Mean for Patients with Tendon Tears?
Taken together, these studies paint an encouraging picture. PRP injections are emerging as a compelling nonsurgical treatment option for partial tendon tears, with clinical evidence increasingly demonstrating that PRP can do more than just alleviate pain — it may actually promote structural healing of torn tissue.
It is already well established that PRP outperforms common treatments like cortisone injections for conditions such as tennis elbow, plantar fasciitis, and knee osteoarthritis. However, the evidence for PRP's ability to heal actual tendon tears was previously lacking. These recent studies change that narrative and suggest that PRP, particularly when combined with barbotage technique, can provide surgical-level results without the associated risks or downtime.
It is important to note that these promising results apply to patients with partial to high-grade tendon tears. For those dealing with full-thickness complete tears where the tendon fibers have retracted, surgery remains the preferred treatment. Additionally, while these findings are encouraging, they still need to be replicated in larger clinical trials before becoming the standard of care.
If you are considering PRP therapy for a tendon injury, I encourage you to learn more about PRP injections or schedule a consultation to discuss whether this treatment is appropriate for your condition.
References
1. de Castro RLB, Antonio BP, Giovannetti GA, Annichino-Bizzacchi JM. Total Healing of a Partial Rupture of the Supraspinatus Tendon Using Barbotage Technique Associated with Platelet-Rich Plasma: A Randomized, Controlled, and Double-Blind Clinical Trial. Biomedicines. 2023;11(7):1849. doi:10.3390/biomedicines11071849
2. Poff G, Spencer E, Scott B, Sleadd R, Broyles J. Comparison of Clinical Outcomes after Platelet-Rich Plasma and Rotator Cuff Repair in High-Grade Intrasubstance Partial Rotator Cuff Tears. J Clin Med. 2023;12(17):5554. doi:10.3390/jcm12175554
3. Rossi LA, Piuzzi N, Tanoira I, Brandariz R, Huespe I, Ranalletta M. Subacromial Platelet-Rich Plasma Injections Produce Significantly Worse Improvement in Functional Outcomes in Patients With Partial Supraspinatus Tears Than in Patients With Isolated Tendinopathy. Arthroscopy. 2023;39(9):2000-2008. doi:10.1016/j.arthro.2023.03.019
4. Keener JD, Hsu JE, Steger-May K, Teefey SA, Chamberlain AM, Yamaguchi K. Patterns of Tear Progression for Asymptomatic Degenerative Rotator Cuff Tears. J Shoulder Elbow Surg. 2015;24(12):1845-1851. doi:10.1016/j.jse.2015.08.038
Medical Disclaimer: This content is for educational purposes only and does not substitute for the medical advice of a physician. Always consult your healthcare provider before beginning any new treatment program. The information presented reflects the opinion of Dr. Jeffrey Peng and does not represent the views of his employers or affiliated hospital systems.
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