Department of Physical Medicine and Rehabilitation, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC.
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2022 Jun 1;85(6):723-729. doi: 10.1097/JCMA.0000000000000736. Epub 2022 Jun 10.
Partial-thickness rotator cuff tears (PTRCTs) is not uncommon, and various nonsurgical injection therapy for PTRCTs emerged. Platelet-rich plasma (PRP) and hyaluronic acid (HA) injection were proposed for treating PTRCTs; however, the relation of dose among injectates was still lacking.
This was a prospective, nonrandomized, comparative study. The aim of the study was to compare the effects of ultrasound-guided single PRP injection with three doses of HA injection, combination of postinjection rehabilitation, for treating PTRCTs. Subjects received either ultrasound-guided PRP injection and rehabilitation exercise, or ultrasound-guided subacromial HA injection and rehabilitation exercise. Shoulder Pain and Disability Index (SPADI), range of motion (ROM), pain visual analog scale (VAS), and Constant-Murley Shoulder Score (CMSS) were recorded before injection, and at 1 and 3 months after injection.
Forty-eight patients were enrolled. They received either ultrasound-guided single PRP (n = 24) intralesional and peritendinous injection or three doses of HA (n = 24) subacromial injection plus rehabilitation exercise. In the PRP group, SPADI scores, VAS scores, CMSS significantly improved at 1-month and 3-month follow up; flexion and abduction ROM significantly increased at 3-month follow up. In the HA group, SPADI scores, VAS during overhead activities, VAS night pain, and CMSS significantly improved in the first and third months; flexion and active abduction ROM significantly increased in the third month. The PRP group revealed significantly better passive abduction ROM and CMSS at third month than HA group.
Ultrasound-guided single PRP injection exhibited comparable benefit to three doses of HA injection in patients with PTRCTs short-termly, with an extended effect regarding passive shoulder abduction ROM and CMSS.
部分厚度肩袖撕裂（PTRCT）并不少见，各种非手术注射疗法也应运而生。富血小板血浆（PRP）和透明质酸（HA）注射被提议用于治疗 PTRCT；然而，注射剂之间的剂量关系仍然缺乏。
这是一项前瞻性、非随机、对照研究。本研究的目的是比较超声引导下单次 PRP 注射与三种剂量 HA 注射联合注射后康复治疗治疗 PTRCT 的效果。受试者接受超声引导下 PRP 注射和康复运动或超声引导下肩峰下 HA 注射和康复运动。在注射前、注射后 1 个月和 3 个月记录肩痛和残疾指数（SPADI）、关节活动度（ROM）、疼痛视觉模拟评分（VAS）和 Constant-Murley 肩部评分（CMSS）。
共纳入 48 例患者。他们接受了超声引导下单次 PRP（n = 24）病灶内和肌腱周围注射或三种剂量 HA（n = 24）肩峰下注射加康复运动。在 PRP 组中，SPADI 评分、VAS 评分、CMSS 在 1 个月和 3 个月随访时显著改善；ROM 在前屈和外展方面在 3 个月随访时显著增加。在 HA 组中，SPADI 评分、 overhead 活动时的 VAS、夜间疼痛的 VAS 和 CMSS 在第一个月和第三个月都有显著改善；ROM 在第三个月显著增加。与 HA 组相比，PRP 组在第三个月时的被动外展 ROM 和 CMSS 明显更好。
超声引导下单次 PRP 注射在 PTRCT 患者中短期疗效与三种剂量 HA 注射相当，在被动肩部外展 ROM 和 CMSS 方面具有更长的效果。
