Tanpowpong Thanathep, Thepsoparn Marvin, Numkarunarunrote Numphung, Itthipanichpong Thun, Limskul Danaithep, Thanphraisan Phark
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Pain Management Research Unit, Department of Anesthesia, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Rama IV Rd, Bangkok, 10330, Thailand.
Sports Med Open. 2023 Feb 8;9(1):11. doi: 10.1186/s40798-023-00556-w.
Corticosteroid (CS) injection is commonly used in partial-thickness rotator cuff tears to decrease pain. However, this could result in unwanted side effects, such as tendon rupture. Alternatively, platelet-rich plasma (PRP) injection is frequently used to treat tendinopathies because it enhances healing. This study aimed to compare the differences in tear size and functional scores between intralesional PRP and subacromial CS injections.
Patients with symptomatic partial-thickness tears of the supraspinatus tendon who underwent conservative treatment for ≥ 3 months were enrolled. All patients underwent magnetic resonance imaging (MRI) to confirm the diagnosis. Fourteen and 15 patients were randomized to receive intralesional PRP and subacromial CS injections, respectively. Tears were measured in the coronal and sagittal planes. The patients underwent another MRI 6 months after the injection. Tear size was compared between the two MRI results. The American Shoulder and Elbow Surgeons Shoulder score (ASES) and Constant-Murley score (CMS) were also obtained.
The baseline data were similar between the groups. In the coronal plane, PRP and CS showed tear size reductions of 3.39 mm (P = 0.003) and 1.10 mm (P = 0.18), respectively. In the sagittal plane, PRP and CS showed tear size reductions of 2.97 mm (P = 0.001) and 0.76 mm (P = 0.29), respectively. Functional scores improved 6 months after injection in both groups, but PRP showed better functional scores than CS (P = 0.002 for ASES, P = 0.02 for CS).
Intralesional PRP injection can reduce the tear size in partial-thickness tears of the supraspinatus tendon. Subacromial steroid injection did not significantly affect the tear size. While CS improved functional scores compared with baseline, PRP resulted in better improvement 6 months post-injection. Trial registration Thai Clinical Trials Registry, TCTR20210428004. Registered 28 April 2021-retrospectively registered, TCTR20210428004 .
皮质类固醇（CS）注射常用于治疗部分厚度肩袖撕裂以减轻疼痛。然而，这可能会导致不必要的副作用，如肌腱断裂。另外，富血小板血浆（PRP）注射常用于治疗肌腱病，因为它能促进愈合。本研究旨在比较病灶内注射PRP与肩峰下注射CS在撕裂大小和功能评分方面的差异。
纳入对有症状的冈上肌腱部分厚度撕裂进行了≥3个月保守治疗的患者。所有患者均接受磁共振成像（MRI）以确诊。分别将14例和15例患者随机分组，接受病灶内PRP注射和肩峰下CS注射。在冠状面和矢状面测量撕裂情况。患者在注射后6个月接受另一次MRI检查。比较两次MRI检查结果的撕裂大小。同时获取美国肩肘外科医师学会肩关节评分（ASES）和Constant-Murley评分（CMS）。
两组间基线数据相似。在冠状面，PRP组和CS组的撕裂大小分别减小了3.39mm（P = 0.003）和1.10mm（P = 0.18）。在矢状面，PRP组和CS组的撕裂大小分别减小了2.97mm（P = 0.001）和0.76mm（P = 0.29）。两组在注射后6个月功能评分均有所改善，但PRP组的功能评分优于CS组（ASES，P = 0.002；CMS，P = 0.02）。
病灶内注射PRP可减小冈上肌腱部分厚度撕裂的大小。肩峰下注射类固醇对撕裂大小无显著影响。虽然CS与基线相比改善了功能评分，但PRP在注射后6个月改善效果更佳。试验注册 泰国临床试验注册中心，TCTR20210428004。2021年4月28日注册——回顾性注册，TCTR20210428004 。
