The Full Answer
Whether PRP is a reasonable alternative to surgery for a partial rotator cuff tear depends heavily on the tear's size, location, and how long symptoms have been present, along with the patient's functional demands (for example, an overhead athlete versus someone with lower physical demands). A small, partial-thickness tear with a short symptom duration is a more reasonable candidate for a PRP-first approach than a larger tear or one that has failed to improve over an extended trial of conservative care.
What the Current Evidence Shows
Research on PRP for partial-thickness rotator cuff tears shows mixed but generally encouraging results for pain and function in appropriately selected patients, while full-thickness tears with significant retraction typically respond better to surgical repair.
Who May Benefit
When Surgery May Be More Appropriate
Larger partial tears, full-thickness tears, significant retraction, or a tear that hasn't responded to an adequate trial of conservative and orthobiologic treatment are generally better addressed surgically.
Dr. Tortland's Perspective
This is decided case by case using imaging and a clear discussion of the trade-offs — PRP is not offered as a way to avoid a conversation about surgery when surgery is genuinely the more appropriate option for that specific tear.