Miranda I, Sánchez-Alepuz E, Lucas F J, Carratalá V, González-Jofre C A
Servicio de Cirugía Ortopédica y Traumatología de Unión de Mutuas, Valencia, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital IMED Valencia, Burjassot, Valencia, España.
Servicio de Cirugía Ortopédica y Traumatología de Unión de Mutuas, Valencia, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital IMED Valencia, Burjassot, Valencia, España.
Rev Esp Cir Ortop Traumatol. 2017 Jul-Aug;61(4):249-258. doi: 10.1016/j.recot.2017.03.001. Epub 2017 May 19.
To analyze the current scientific and/or clinical evidence supporting the use of platelet-rich plasma (PRP) in the treatment of rotator cuff pathology.
After a systematic review in PubMed, studies assessing PRP efficacy in the treatment of rotator cuff pathology published since 2013 to date were identified. Data were grouped based on type of study (laboratory, clinical or meta-analysis); accordingly study design, pathology treated and clinical outcomes were summarized.
Thirty five articles have been analyzed: 10 laboratory studies, 17 clinical assays and 8 meta-analyses. While laboratory studies report positive or partially positive results for the use of PRP, 70.6% of clinical studies and 75% of meta-analysis found no statistically significant differences between the PRP group and the control group.
The positive results of laboratory studies do not translate well to clinical practice. There is no concordance among the few positive results reported in the clinical studies, and even some contradictory effects have been reported.
There is no solid scientific and/or clinical evidence supporting the use of PRP in the treatment of rotator cuff pathology in routine clinical practice.
分析目前支持使用富血小板血浆(PRP)治疗肩袖损伤的科学和/或临床证据。
在PubMed上进行系统检索后,确定了2013年至今发表的评估PRP治疗肩袖损伤疗效的研究。根据研究类型(实验室研究、临床研究或荟萃分析)对数据进行分组;相应地,总结了研究设计、治疗的病理情况和临床结果。
共分析了35篇文章:10篇实验室研究、17篇临床研究和8篇荟萃分析。虽然实验室研究报告了使用PRP的阳性或部分阳性结果,但70.6%的临床研究和75%的荟萃分析发现PRP组与对照组之间无统计学显著差异。
实验室研究的阳性结果在临床实践中未能很好地转化。临床研究中报告的少数阳性结果之间缺乏一致性,甚至还报告了一些矛盾的效果。
在常规临床实践中,没有确凿的科学和/或临床证据支持使用PRP治疗肩袖损伤。