Ackley J Freeland, Kolosky Michael, Gurin Danielle, Hampton Robert, Masin Richard, Krahe David
Twinsburg Family Health and Surgery Center, Twinsburg, OH.
Southwest Sports Medicine, Waco, TX.
Medicine (Baltimore). 2019 Jul;98(30):e16569. doi: 10.1097/MD.0000000000016569.
Amniotic membrane (AM) and umbilical cord (UC) are well known to have anti-inflammatory properties and have been shown to promote healing in various orthopedic indications. This study investigated whether intra-articular injection of AM/UC particulate matrix promotes healing of partial rotator cuff tears (RCTs).A case series was performed on 10 patients that received injection of 50 mg AM/UC for partial RCTs that were refractory to conservative treatment. Outcomes included Penn Shoulder Score (PSS) questionnaire, range of motion examination, and magnetic resonance imaging (MRI) analysis before and at 6 months. Final MRI analysis was performed by a musculoskeletal radiologist in a blinded fashion.Average PSS score (out of 100) increased from 46.8 ± 23.7 at baseline to 82.0 ± 19.1 at 6 months. The average PSS sub-scores of pain, satisfaction, and function increased 78.4%, 37.1%, and 82.3% from baseline, respectively. The subject's range of motion was 77.9% at baseline and increased to 99.9% at 6-months. Follow-up MRI scans did not demonstrate any significant change in RCT size. No adverse events were noted.This small case series provides preliminary data for use of cryopreserved AM/UC particulate matrix in patients with refractory partial RCTs.
羊膜(AM)和脐带(UC)具有抗炎特性,并且已被证明可促进各种骨科适应症的愈合。本研究调查了关节内注射AM/UC颗粒基质是否能促进部分肩袖撕裂(RCT)的愈合。
对10例接受50mg AM/UC注射治疗难治性部分RCT的患者进行了病例系列研究。结果包括宾夕法尼亚肩部评分(PSS)问卷、活动范围检查以及治疗前和6个月时的磁共振成像(MRI)分析。最终的MRI分析由一名肌肉骨骼放射科医生以盲法进行。
PSS平均评分(满分100分)从基线时的46.8±23.7提高到6个月时的82.0±19.1。疼痛、满意度和功能的PSS平均子评分分别比基线时提高了78.4%、37.1%和82.3%。受试者的活动范围在基线时为77.9%,6个月时增加到99.9%。随访MRI扫描未显示RCT大小有任何显著变化。未观察到不良事件。
这个小病例系列为在难治性部分RCT患者中使用冷冻保存的AM/UC颗粒基质提供了初步数据。