Lee Ho-Won, Choi Kyung-Ho, Kim Jung-Youn, Yang Ik, Noh Kyu-Cheol
Department of Orthopedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Clin Shoulder Elb. 2019 Jun 1;22(2):61-69. doi: 10.5397/cise.2019.22.2.61. eCollection 2019 Jun.
The purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP.
Inclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure.
There was a statistically significant difference in ΔASES (ASES-ASES) score between the control and PRP groups (=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (>0.05).
This study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.
本研究旨在比较在门诊接受保守治疗无效的肩袖肌腱病患者中,对照组与富血小板血浆(PRP)组的临床疗效,并比较贫白细胞(LP)PRP和富白细胞(LR)PRP的临床效果。
纳入标准为:(1)年龄超过18岁;(2)肩袖肌腱病患者,在过去3个月内经放射学诊断(超声或磁共振成像)无肩袖撕裂;(3)保守治疗1个月以上无效。最终的60名受试者中,运动治疗组33例患者,PRP注射组27例患者(LP-PRP组13例,LR-PRP组14例)。通过使用数字评分量表疼痛评分、美国肩肘协会(ASES)评分以及Constant评分,在基线时以及术后3个月和6个月评估治疗结果,进行临床评价。
对照组和PRP组之间的ΔASES(ASES - ASES)评分存在统计学显著差异(=0.006)。然而,LP-PRP组和LR-PRP组之间无统计学意义(>0.05)。
本研究表明,在最初3个月内,PRP注射比运动疗法更有效。然而,LP-PRP组和LR-PRP组之间没有差异。无论PRP的类型如何,PRP注射在肩袖肌腱病患者中的临床应用在早期治疗中似乎是有效的。