scholarly journals Prospective Clinical Research of the Efficacy of Platelet-rich Plasma in the Outpatient-based Treatment of Rotator Cuff Tendinopathy

2019 ◽  
Vol 22 (2) ◽  
pp. 61-69
Author(s):  
Ho-Won Lee ◽  
Kyung-Ho Choi ◽  
Jung-Youn Kim ◽  
Ik Yang ◽  
Kyu-Cheol Noh
Keyword(s):  
Rotator Cuff ◽  
Conservative Treatment ◽  
Rating Scale ◽  
Platelet Rich Plasma ◽  
Constant Score ◽  
Statistical Significance ◽  
Clinical Results ◽  
Control Group ◽  
Significant Difference ◽  
Rotator Cuff Tendinopathy

Background: The purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP.Methods: Inclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure.Results: There was a statistically significant difference in ΔASES<sub>3months</sub> (ASES<sub>3months</sub>-ASES<sub>first</sub>) score between the control and PRP groups (<i>p</i>=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (<i>p</i>>0.05).Conclusions: This study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.

scholarly journals The influence of the Kinesio Taping on selected ultrasonography measurements, and quality of life in patients with rotator cuff lesions

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Aneta Bac ◽  
Magdalena Wróbel ◽  
Katarzyna Ogrodzka-Ciechanowicz ◽  
Edyta Michalik ◽  
Anna Ścisłowska-Czarnecka
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Statistical Significance ◽  
Control Group ◽  
Subacromial Space ◽  
Kinesio Taping ◽  
Significant Difference ◽  
Rotator Cuff Lesions ◽  
Significant Change

Abstract The assessment of the six-week influence of Kinesio Taping combined with a rehabilitation on selected ultrasonography measurements, the level of disability, and the quality of life in patients with rotator cuff lesions. 60 participants were randomly assigned into a taping group (KT combined with a six-week rehabilitating protocol) and a control group (only rehabilitation protocol). In all patients the following assessments were performed twice: USG, UEFI and NHP questionnaires. In the examination of the subacromial space and the subacromial bursa in the taping group, no statistical significance was observed. A statistically significant change in the thickness of the muscles was obtained only for the thickness of the infraspinatus in the taping group. A statistically significant change was obtained in the assessment of tendinopathy only for the supraspinatus muscle in both groups. Within both groups a statistically significant difference was observed in the average UEFI and NHP scores; however, the differences in the scores obtained between the groups were not statistically significant. The use of KT with a rehabilitation program did not yield statistically significantly better results in the improvement of selected shoulder region indicators, the function of the upper limb and the quality of life.

scholarly journals Tissue Engineering for Rotator Cuff Repair: An Evidence-Based Systematic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Nicola Maffulli ◽  
Umile Giuseppe Longo ◽  
Mattia Loppini ◽  
Alessandra Berton ◽  
Filippo Spiezia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tissue Engineering ◽  
Stem Cells ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Control Group ◽  
Tissue Engineering Application ◽  
Significant Difference ◽  
Cuff Repair

The purpose of this systematic review was to address the treatment of rotator cuff tears by applying tissue engineering approaches to improve tendon healing, specifically platelet rich plasma (PRP) augmentation, stem cells, and scaffolds. Our systematic search was performed using the combination of the following terms: “rotator cuff”, “shoulder”, “PRP”, “platelet rich plasma”, “stemcells”, “scaffold”, “growth factors”, and “tissue engineering”. No level I or II studies were found on the use of scaffolds and stem cells for rotator cuff repair. Three studies compared rotator cuff repair with or without PRP augmentation. All authors performed arthroscopic rotator cuff repair with different techniques of suture anchor fixation and different PRP augmentation. The three studies found no difference in clinical rating scales and functional outcomes between PRP and control groups. Only one study showed clinical statistically significant difference between the two groups at the 3-month followup. Any statistically significant difference in the rates of tendon rerupture between the control group and the PRP group was found using the magnetic resonance imaging. The current literature on tissue engineering application for rotator cuff repair is scanty. Comparative studies included in this review suggest that PRP augmented repair of a rotator cuff does not yield improved functional and clinical outcome compared with non-augmented repair at a medium and long-term followup.

scholarly journals Repair Integrity and Functional Outcomes after Arthroscopic Repair of Transtendinous Full-thickness Rotator Cuff Tears Minimum Two-year Follow-up

2017 ◽  
Vol 20 (4) ◽  
pp. 183-188
Author(s):  
Kyung Cheon Kim ◽  
Woo Yong Lee ◽  
Hyun Dae Shin ◽  
Young Mo Kim ◽  
Sun Cheol Han
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Rating Scale ◽  
Clinical Results ◽  
Arthroscopic Repair ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Significant Difference ◽  
The University

BACKGROUND: To evaluate the clinical outcomes and associated repair integrity in patients treated with arthroscopic repair for a transtendinous rotator cuff tear followed by resection of the remnant rotator cuff tendon.METHODS: Between July 2007 and July 2011, we retrospectively reviewed patients who were treated for transtendinous full-thickness tears in the tendinous portion of the rotator cuff by arthroscopic repair. Clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), the Constant-Murley score, a visual analogue scale (VAS) pain score, and range of motion (ROM). The repair integrity was determined by magnetic resonance imaging or ultrasonography.RESULTS: There were 19 shoulders with transtendinous full-thickness tears in the tendinous portion of the rotator cuff. The ASES, UCLA, Constant-Murley, and VAS pain scores showed significant improvements in function and symptoms (all p<0.001). The active ROM for forward flexion and abduction was also significantly improved (p=0.002 and p<0.001, respectively). The postoperative radiological examination showed cuff integrity without a re-tear in 68.4% of patients. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and re-torn group (p=0.530, p=0.885, and p=0.262, respectively).CONCLUSIONS: Although repair of transtendinous rotator cuff tears followed by resection of the remnant rotator cuff tendon in the footprint has a relatively high re-tear rate, no significant difference was observed in the short-term clinical results between the re-tear and healed groups.

scholarly journals Role of Ultrasound Guided Injection of Platelet Rich Plasma (PRP) in Rotator Cuff Tendinopathy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
G M Niazy ◽  
A H Ali ◽  
M S S Mahmoud
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Radiology Department ◽  
P Value ◽  
Ultrasound Guided ◽  
University Hospitals ◽  
Significant Difference ◽  
Tendon Thickness ◽  
Rotator Cuff Tendinopathy

Abstract Background Rotator cuff tendinopathy is a leading cause of shoulder pain and a significant source of disability. It is a common disorder, with its prevalence increasing substantially with age and affecting more than 50% of the general population by the age of 60 years Objectives Based on these facts, our study efforts seeked assessment of the role of ultrasound guided platelet rich plasma injection (PRP) in cases of rotator cuff tendinopathy. Patients and Methods Type of Study is single arm interventional study was conducted in Ain shams university hospitals in the period between October 2018 and March 2019, 15 patients were included in the study ranging from 25 to 60 years old, were referred to the Radiology department at Ain Shams University Hospitals. Study Setting: all US examinations were performed by the same senior musculoskeletal radiologist with a large experience in the musculoskeletal US at the radiology department of Ain Shams University hospitals. Study Period: 6 months for data collection. Results Our study showed remarkably noticeable change on comparing the pre-injection and post-injection SPADI Scoring system at 4,8,12 and 24 weeks. There is highly statistically significant pain and disability score and percentage improvement, yet on the other hand the radiological improvement shows no statistically significant difference found between baseline tendon thickness and its follow up at 4, 8 and 12 weeks while only there was statistically significant decrease in tendon thickness found at 24 weeks with p-value = 0.043. Conclusion The ultrasound-guided PRP injection for supraspinatus tendinopathy cases is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising, and well-proved results when compared to other modalities outcomes such as conventional surgeries, arthroscopic procedures, and physiotherapy. It deserves our attention to its value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life.

Rotator Cuff Matrix Augmentation and Interposition: A Systematic Review and Meta-analysis

2018 ◽  
Vol 47 (6) ◽  
pp. 1496-1506 ◽  
Author(s):  
James R. Bailey ◽  
Christopher Kim ◽  
Eduard Alentorn-Geli ◽  
Donald T. Kirkendall ◽  
Leila Ledbetter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Los Angeles ◽  
Rotator Cuff ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Reverse Shoulder Arthroplasty ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Surgical Interventions

Background: Surgical management of rotator cuff tears is controversial and complex, ranging from nonoperative management to reverse shoulder arthroplasty. Purpose: To systematically review and evaluate the outcomes of graft augmentation or interposition versus rotator cuff repair (RCR) alone and evaluate via meta-analysis whether the use of a graft leads to superior outcomes versus RCR alone. Study Design: Systematic review and meta-analysis. Methods: An electronic literature search (Medline, Embase, CINAHL) was conducted. Studies with a minimum follow-up of 1 year and minimum sample size of 10 that provided clinical results of RCR or rotator cuff reconstruction using any type of augmentation tissue or matrix were included. Methodological quality was evaluated by assessment of the risk of bias in the included studies. Studies comparing outcomes of RCR with graft augmentation or interposition versus repair alone (control group) were subjected to meta-analysis. Results: The authors identified 774 articles and included 36 in the systematic review; 5 of the 36 studies underwent meta-analysis. Except for one outcome measure in a single study, all surgical interventions (RCR alone, RCR with augmentation, and RCR with interposition) improved clinical scores and outcome measures. Because of variability in study outcomes, no graft option was found to be superior. Compared with RCR alone, graft augmentation or interposition provided significantly lower retear rates ( P = .05) and higher American Shoulder and Elbow Surgeons (ASES) scores ( P = .005), but improvements in UCLA (University of California, Los Angeles) scores ( P = .29) and pain scores ( P = .1) did not reach statistical significance. Conclusion: In the meta-analysis, graft augmentation or interposition appeared to provide a lower retear rate and improved ASES scores when compared with RCR alone. Future prospective, randomized, controlled, and appropriately powered trials are needed for more definitive recommendations.

scholarly journals Clinical Evaluations of Intraoperative Injection of Platelet-Rich Plasma in Arthroscopic Single-Row Rotator Cuff Repair at 2-Year Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ming Li ◽  
Kan Wang ◽  
Haojun Zhang ◽  
Chaohua Fang ◽  
Hua Liu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Operation Time ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
And Control ◽  
Retear Rate

Background. The clinical evidence is conflicted on whether platelet-rich plasma (PRP) therapies have a positive effect on tendon healing and improved functional outcomes. Purpose. To evaluate the potentials of intraoperative injection PRP on the speed and quality of healing in patients undergoing arthroscopic repair for small to medium rotator cuff tears. Methods. A total of 86 patients scheduled for arthroscopic single-row repair of small to medium rotator cuff tears were assigned to undergo either PRP injection (PRP group) or conventional repair (control group). The PRP group ( N = 43 ) consisted of patients who received an intraoperative injection of liquid PRP. The control group ( N = 43 ) consisted of patients who did not receive that treatment. The visual analogue scale (VAS) for pain before treatment and at 1, 14 days, 3, 6, and 24 months after surgery were recorded. The clinical outcomes were assessed by the University of California, Los Angeles (UCLA) and Constant scores before treatment and at 3, 6, and 24 months after surgery and magnetic resonance imaging or ultrasound examination at 24 months. Patient satisfaction and retear rate were also assessed. Results. No statistical differences in baseline characteristics such as age, gender, dominant arm, and tear size were observed between the two groups ( P > 0.05 ). For the PRP group, the mean operation time was 40.22 minutes, and for the control group, the mean operation time was 36.3 minutes. There was a statistically significant difference ( P = 0.036 ). After surgery, all VAS measurements significantly decreased over time until final follow-up in both groups. No significant difference between the 2 groups was found for any VAS pain measurement at any time point except for the VAS at 1 day postoperatively, which was significantly lower in the PRP group ( 2.39 ± 1.03 ) than that in the control group ( 3.21 ± 1.85 ) ( P = 0.014 ). Analysis of the PRP and control groups demonstrated a statistically significant improvement in UCLA and Constant scores from baseline to the 3-, 6-, and 24-month follow-up assessments ( P < 0.05 ). However, no significant intergroup differences were observed in the clinical scores between the three follow-up time points ( P > 0.05 ). At the 24-month follow-up, patient satisfaction rates reached 95.65% and 93.48% for the PRP and control groups, respectively. The retear rate of the PRP group (2/43, 4.65%) was lower than that of the control group (6/43, 13.95%). Conclusions. Although the pain at 1 day after surgery and the retear rate in the PRP group were significantly lower than those in the control group, the liquid PRP injection did not promote better clinical outcomes at the 2-year follow-up.

scholarly journals Clinical results of conservative management in patients with full-thickness rotator cuff tear: a meta-analysis

2020 ◽  
Author(s):  
Masaki Karasuyama ◽  
Masafumi Gotoh ◽  
Keiji Tahara ◽  
Junichi Kawakami ◽  
Kazuya Madokoro ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Conservative Treatment ◽  
Short Form ◽  
Constant Score ◽  
Meta Analysis ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Cochrane Library ◽  
Full Thickness ◽  
Short Form 36

Background: Several systematic reviews have reported on the conservative treatment of full-thickness rotator cuff tears; however, clinical results of this treatment still remain determined. Methods: PubMed, Cochrane Library, PEDro, and CINAHL databases were systematically searched for randomized clinical trials and observational studies. Two independent researchers reviewed a total of 2,981 articles, 28 of which met the criteria for inclusion in the study. Clinical outcome measures included Constant score, visual analog scale score for pain, range of motion, and short-form 36. The meta-analysis used a linear mixed model weighted with the variance of the estimate. Results: The meta-analysis showed a significant improvement after surgery. Pain score is 26.2 mm (1 month) to 26.4 mm (3 months) and 24.8 mm (12 months) (P<0.05); active abduction: 153.2º (2 months), 159.0º (6 months), 168.1º (12 months) (P<0.05); Constant score: 67.8 points (2 months) to 77.2 points (12 months) (P<0.05); short-form 36 “vitality” section: 57.0 points (6 months) and 70.0 points (12 months) (P<0.05). Conclusions: Our data confirmed the effectiveness of conservative treatment in patients with full-thickness rotator cuff tears 12 months post-intervention. The results suggest that conservative treatment for patients with full-thickness rotator cuff tears should be the first line of treatment before considering surgery.

Can a Double-Row Anchorage Technique Improve Tendon Healing in Arthroscopic Rotator Cuff Repair?

2007 ◽  
Vol 35 (8) ◽  
pp. 1247-1253 ◽  
Author(s):  
Christophe Charousset ◽  
Jean Grimberg ◽  
Louis Denis Duranthon ◽  
Laurance Bellaiche ◽  
David Petrover
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Tendon Healing ◽  
Clinical Results ◽  
Level Of Evidence ◽  
Double Row ◽  
Single Row ◽  
Significant Difference ◽  
Cuff Repair

Background Increasing the rate of watertight tendon healing has been suggested as an important criterion for optimizing clinical results in rotator cuff arthroscopic repair. Hypothesis A double-row anchorage technique for rotator cuff repair will produce better clinical results and a better rate of tendon healing than a single-row technique. Study Design Cohort study; Level of evidence, 2. Methods We compared 31 patients undergoing surgery with a double-row anchorage technique using Panalok anchors and Cuff Tack anchors and 35 patients with rotator cuff tear undergoing surgery with a single-row anchorage arthroscopic technique using Panalok anchors. We compared pre- and postoperative Constant score and tendon healing, as evaluated by computed tomographic arthrography 6 months after surgery, in these 2 groups. Results The Constant score increased significantly in both groups, with no difference between the 2 groups (P = .4). Rotator cuff healing was judged anatomic in 19 patients with double-row anchorage and in 14 patients with single-row anchorage; this difference between the groups was significant (P = .03). Conclusion In this first study comparing double- and single-row anchorage techniques, we found no significant difference in clinical results, but tendon healing rates were better with the double-row anchorage. Improvements in the double-row technique might lead to better clinical and tendon healing results.

scholarly journals Effectiveness of Platelet-Rich Plasma Injection in Rotator Cuff Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 189 ◽  
Author(s):  
Meng-Ting Lin ◽  
Kuo-Chang Wei ◽  
Chueh-Hung Wu
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Pain Reduction ◽  
Functional Improvement ◽  
Control Group ◽  
Sham Injection ◽  
Randomized Controlled ◽  
Rotator Cuff Tendinopathy

Background: To investigate the effectiveness of platelet-rich plasma (PRP) injection among patients with rotator cuff tendinopathy in comparison with sham injection, no injection, or physiotherapy alone. Methods: From the earliest records to November 1, 2018, all published or unpublished randomized controlled trial (RCTs) comparing PRP injection with a control group (sham injection, no injection, or physiotherapy alone) in patients with rotator cuff tendinopathy were included. Eligible trials were included from the search results of electronic databases including PubMed, EMBASE, Scopus, The Cochrane Library, as well as the bibliographies of relevant trials. Five RCTs were enrolled in our meta-analysis. Two authors independently assessed the quality of RCTs with the Cochrane risk of bias tool. We designated pain reduction as the primary outcome and functional improvement as the secondary outcome. Standardized mean difference (SMD) was applied for random-effect meta-analysis. Results: In the short term (3–6 weeks) and medium term (12 weeks), the effectiveness of PRP injection and control group was indistinguishable in terms of both outcomes (pain reduction and functional improvement). Nevertheless, PRP injection led to significant long-term (>24 weeks) pain relief (SMD: 0.42, 95% confidence interval (CI): 0.12–0.72, without heterogeneity). For functional improvement in the long term, PRP injection was not more effective than the control group (SMD: 1.20, 95% CI: −0.20–2.59, with heterogeneity). Conclusions: PRP injection may provide benefit over the control group (sham injection, no injection, or physiotherapy alone) in reducing pain at long-term follow-up for patients with rotator cuff tendinopathy.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

Sign in / Sign up

Export Citation Format

Share Document