In vivo clinical and radiological effects of platelet-rich plasma on interstitial supraspinatus lesion: Case series - 01/12/16
, M.A. Zumstein d , F.C. Kolo e , M. Grosclaude f , L. Koglin f , A.J.P. Schwitzguebel a
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Abstract |
Background |
Rotator cuff tear (RCT) is a frequent condition of clinical relevance that can be managed with a symptomatic conservative treatment, but surgery is often needed. Biological components like leukocytes and platelet rich plasma (L-PRP) could represent an alternative curative method for interstitial RCT.
Hypotheses |
It has been hypothesized that an ultrasound guided L-PRP injection in supraspinatus interstitial RCT could induce radiological healing.
Material and methods |
A prospective case series including 25 patients was performed in order to assess the effect of L-PRP infiltration into supraspinatus interstitial RCTs. Primary outcome was tear size change determined by magnetic resonance imaging arthrogram (MRA) before and 6 months after L-PRP infiltration. Secondary outcomes were Constant score, SANE score, and pain visual analog scale (VAS) after L-PRP infiltration.
Results |
Tear volume diminution was statistically significant (P=.007), and a >50% tear volume diminution was observed in 15 patients. A statistically significant improvement of Constant score (P<.001), SANE score (P=.001), and VAS (P<.001) was observed. In 21 patients, Constant score improvement reached the minimal clinical important difference of 10.4 points.
Discussion |
We observed a statistically significant and clinically relevant effect on RCT size and clinical parameters after L-PRP infiltration. Such an important improvement of supraspinatus interstitial RCT with conservative management is uncommon, therefore intratendinous L-PRP infiltrations could have been beneficial. This encouraging result could pave the way for future randomized studies in order to formally determinate whether L-PRP infiltrations are a possible alternative to surgical treatment of interstitial RCT.
Level of evidence |
Prospective observational study; Level of evidence II.
Le texte complet de cet article est disponible en PDF.Abbreviations : RCT, L-PRP, MRA, VAS, NSAIDs, PRC, MCID
Keywords : Rotator cuff lesion, Supraspinatus, Leukocyte rich-platelet-rich plasma (L-PRP), Growth factor, Platelets
Plan
Vol 102 - N° 8
P. 977-982 - décembre 2016 Retour au numéro
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