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超声引导下富血小板血浆、注射疗法和皮质类固醇注射治疗肩袖损伤的比较。

Comparison of ultrasound-guided platelet-rich plasma, prolotherapy, and corticosteroid injections in rotator cuff lesions.

作者信息

Sari Aylin, Eroglu Ali

机构信息

Erenkoy Physical Therapy and Rehabilitation Hospital, Physical Medicine and Rehabilitation Clinic, Istanbul, Turkey.

Erenkoy Physical Therapy and Rehabilitation Hospital, Sports Medicine Clinic, Istanbul, Turkey.

出版信息

J Back Musculoskelet Rehabil. 2020;33(3):387-396. doi: 10.3233/BMR-191519.

Abstract

BACKGROUND

Injections are a good alternative to conventional treatment-resistant cases with rotator cuff (RC) lesions before operation. Currently, different injection methods are used in RC lesions.

OBJECTIVE

To evaluate the efficacy of different injection methods (platelet-rich plasma [PRP], corticosteroid [COR] and prolotherapy [PRO]) in RC tendon lesions.

METHODS

One hundred and twenty-nine patients were divided into 4 groups as PRP, COR, PRO and the lidocaine group. Subacromial injection was applied to all groups. They were evaluated using the Visual Analogue Scale (VAS), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and Western Ontario Rotator Cuff Index (WORC) at 3, 12 and 24 weeks post-injection.

RESULTS

In the COR group in the 3rd week, VAS and WORC scores were significantly lower than the other groups (p< 0.01 and p< 0.05 respectively). In the PRP group in the 24th week, VAS and WORC scores were found to be significantly lower than the COR group (p< 0.01 and p< 0.05 respectively). In the COR group in the 3rd week the ASES score was found to be significantly higher than the PRP and PRO group (p< 0.01).

CONCLUSION

In patients with RC lesions, corticosteroid injection provides short-term relief for pain, function, and quality of life, while PRP injection works for long-term wellbeing. For all types of applied injections, improvement in pain, function and quality of life were observed.

摘要

背景

对于术前常规治疗无效的肩袖(RC)损伤病例,注射治疗是一种很好的替代方法。目前,在RC损伤中使用了不同的注射方法。

目的

评估不同注射方法(富血小板血浆[PRP]、皮质类固醇[COR]和注射疗法[PRO])治疗RC肌腱损伤的疗效。

方法

129例患者分为PRP组、COR组、PRO组和利多卡因组4组。所有组均采用肩峰下注射。在注射后3周、12周和24周,使用视觉模拟量表(VAS)、美国肩肘外科医生标准化肩部评估表(ASES)和西安大略肩袖指数(WORC)对患者进行评估。

结果

在第3周时,COR组的VAS和WORC评分显著低于其他组(分别为p<0.01和p<0.05)。在第24周时,PRP组的VAS和WORC评分显著低于COR组(分别为p<0.01和p<0.05)。在第3周时,COR组的ASES评分显著高于PRP组和PRO组(p<0.01)。

结论

对于RC损伤患者,皮质类固醇注射可在短期内缓解疼痛、改善功能和提高生活质量,而PRP注射则对长期健康有益。对于所有类型的注射治疗,均观察到疼痛、功能和生活质量有所改善。

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