Lee James J, Harrison Julian R, Boachie-Adjei Kwadwo, Vargas Elizabeth, Moley Peter J
Hospital for Special Surgery, New York, New York, USA.
Orthop J Sports Med. 2016 Nov 9;4(11):2325967116671692. doi: 10.1177/2325967116671692. eCollection 2016 Nov.
Gluteal tendinopathy is a prevalent condition that can be associated with significant pain and disability. To date, no studies have prospectively assessed the efficacy of intratendinous platelet-rich plasma (PRP) injections as a minimally invasive treatment for gluteus medius tendinopathy.
To prospectively assess the efficacy of intratendinous PRP injections as treatment for chronic recalcitrant gluteus medius tendinopathy.
Case series; Level of evidence, 4.
During the study period between July 2011 and November 2015, data were collected from the Hospital for Special Surgery Center for Hip Preservation Outcomes Registry on participants who underwent ultrasound-guided intratendinous PRP injections for recalcitrant gluteus medius tendinosis and/or partial tears of the tendon associated with moderate to severe lateral hip pain for longer than 3 months. All participants were assessed pre- and postinjection with 4 outcome measures: modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living subscale (HOS-ADL), Hip Outcome Score-Sport-Specific subscale (HOS-Sport), and the International Hip Outcome Tool-33 (iHOT-33). Demographic data, including age, sex, height, weight, body mass index, and smoking status, were also collected.
A total of 21 patients were included in the study, with a mean follow-up of 19.7 months (range, 12.1-32.3 months). The mean improvements from preinjection to postinjection follow-up were 56.73 to 74.17 for mHHS, 68.93 to 84.14 for HOS-ADL, 45.54 to 66.72 for HOS-Sport, and 34.06 to 66.33 for iHOT-33. All mean outcome measure improvements were clinically and statistically significant ( < .001). Length of follow-up was positively correlated with improvements in HOS-ADL ( = .021) and HOS-Sport ( = .004) scores. No adverse events were observed during or after the procedure.
In this registry study with prospective follow-up, we found ultrasound-guided intratendinous PRP injections to be a safe and effective treatment option for chronic recalcitrant gluteus medius tendinopathy due to moderate to severe tendinosis and/or partial tendon tears. Well-powered randomized controlled studies are warranted to confirm our findings and further define the ideal candidates for this treatment.
臀肌肌腱病是一种常见病症，可伴有严重疼痛和功能障碍。迄今为止，尚无研究前瞻性评估肌腱内注射富血小板血浆（PRP）作为臀中肌肌腱病微创治疗方法的疗效。
前瞻性评估肌腱内注射PRP治疗慢性顽固性臀中肌肌腱病的疗效。
病例系列；证据等级，4级。
在2011年7月至2015年11月的研究期间，从特种外科医院髋关节保髋结果登记处收集数据，纳入因顽固性臀中肌肌腱病和/或肌腱部分撕裂伴中至重度髋关节外侧疼痛超过3个月而接受超声引导下肌腱内PRP注射的参与者。所有参与者在注射前后均采用4种疗效指标进行评估：改良Harris髋关节评分（mHHS）、髋关节功能评分-日常生活活动分量表（HOS-ADL）、髋关节功能评分-运动特定分量表（HOS-Sport）和国际髋关节功能工具-33（iHOT-33）。还收集了人口统计学数据，包括年龄、性别、身高、体重、体重指数和吸烟状况。
本研究共纳入21例患者，平均随访19.7个月（范围12.1 - 32.3个月）。从注射前到注射后随访，mHHS的平均改善值为56.73至74.17，HOS-ADL为68.93至84.14，HOS-Sport为45.54至66.72，iHOT-33为34.06至66.33。所有疗效指标的平均改善在临床和统计学上均具有显著意义（P <.001）。随访时间与HOS-ADL（P =.021）和HOS-Sport（P =.004）评分的改善呈正相关。在手术期间或术后未观察到不良事件。
在这项具有前瞻性随访的登记研究中，我们发现超声引导下肌腱内注射PRP是治疗因中至重度肌腱病和/或肌腱部分撕裂所致慢性顽固性臀中肌肌腱病安全有效的治疗选择。需要开展有力的随机对照研究以证实我们的发现，并进一步明确该治疗的理想候选者。
