Do Hyun-Kyung, Lee Joong-Hoon, Lim Jae-Young
a Department of Rehabilitation Medicine , Seoul National University College of Medicine, Seoul National University Bundang Hospital , Seongnam-si , Gyeonggi-do , South Korea.
Phys Sportsmed. 2018 May;46(2):213-220. doi: 10.1080/00913847.2018.1450059. Epub 2018 Mar 14.
Polydeoxyribonucleotide as adenosine receptor (A) agonist has been used in plastic surgery and dermatology related to its regenerative property. The aim of this pilot study is to evaluate the safety and efficacy of polydeoxynucleotide injection in patients with rotator cuff tears by a variety of outcomes including pain, disability, physical performance test, and ultrasonography (US).
Seventeen patients (9 men, 8 women, age: 57.9 ± 9.1) with partial-thickness tear of supraspinatus tendon were evaluated in a prospective, open-label, and pre-and-post study. Seventeen patients underwent 3 times intra-lesional polydeoxynucleotide injection under ultrasound (US) guidance on weeks 0, 2 and 4. The safety and efficacy were assessed on weeks 0, 6 and 12. Main outcome measures included shoulder pain on Visual Analogue Scale (VAS) and DASH (disabilities of arm, hand, shoulder) score, range of motion in shoulder, shoulder strength and tear volume (cm) by US. Adverse events were monitored. (CRIS: https://www.cris.nih.go.kr , KCT0000767).
Active shoulder pain on VAS reduced from 5.53 to 3.53 (P = 0.016), and acting pain, one of DASH questionnaires, reduced from 3.35 to 2.00 (P < 0.001). However, resting shoulder pain on VAS and total DASH scores were not significantly different. Forward flexion and internal rotation in range of motion improved significantly (from 169.41 to 178.13 degrees [P = 0.004] and from 83.53 to 88.75 degrees [P = 0.014], respectively). The volume of torn lesion decreased during the study period, however it was not significant. There were no significant adverse events leading to hospitalization.
Minimally invasive procedure through polydeoxynucleotide injection into torn area of supraspinatus tendon on US could be candidate for the safe and effective treatment on shoulder pain and limited range of motion in patients with rotator cuff tear.
聚脱氧核苷酸作为腺苷受体（A）激动剂，因其再生特性已被应用于整形手术和皮肤科。本初步研究的目的是通过多种指标，包括疼痛、功能障碍、身体性能测试和超声检查（US），评估聚脱氧核苷酸注射治疗肩袖撕裂患者的安全性和有效性。
对17例冈上肌腱部分厚度撕裂的患者（9例男性，8例女性，年龄：57.9±9.1）进行了一项前瞻性、开放标签的前后对照研究。17例患者在第0、2和4周接受了3次超声引导下的病灶内聚脱氧核苷酸注射。在第0、6和12周评估安全性和有效性。主要结局指标包括视觉模拟量表（VAS）上的肩部疼痛和DASH（手臂、手部、肩部功能障碍）评分、肩部活动范围、肩部力量以及超声检查的撕裂体积（cm）。监测不良事件。（CRIS：https://www.cris.nih.go.kr，KCT0000767）
VAS上的肩部主动疼痛从5.53降至3.53（P = 0.016），DASH问卷中的活动疼痛从3.35降至2.00（P < 0.001）。然而，VAS上的肩部静息疼痛和DASH总分无显著差异。活动范围中的前屈和内旋显著改善（分别从169.41度增至178.13度[P = 0.004]和从83.53度增至88.75度[P = 0.014]）。在研究期间，撕裂病灶的体积减小，但不显著。没有导致住院的显著不良事件。
通过超声引导将聚脱氧核苷酸注射到冈上肌腱撕裂区域的微创手术，可能是治疗肩袖撕裂患者肩部疼痛和活动范围受限的安全有效方法。
