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影像引导下富血小板血浆注射在肩袖肌腱撕裂患者治疗中的作用

Role of Image-guided Platelet-rich Plasma Injection in the Management of Patients of Supraspinatus Tendon Tear.

作者信息

Tripathi Swati, Ahmad Mehtab, Khan Mohammad Jesan, Anwer Adnan, Firoz M Ahsan, Harun Faisal

机构信息

Department of Radio-Diagnosis, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

出版信息

J Orthop Case Rep. 2024 Dec;14(12):257-262. doi: 10.13107/jocr.2024.v14.i12.5090.

Abstract

INTRODUCTION

Supraspinatus tendinopathy is a common reason for shoulder pain, with or without an associated cuff tear. Various modalities of treatment have been described in literature such as physiotherapy, analgesics, corticosteroid injection, surgical repair (open or arthroscopic), and platelet-rich plasma (PRP) injection. Recently, there has been an increasing trend of PRP injection for rotator cuff arthropathy. Hence, we conducted a study to assess the effectiveness of PRP injection under ultrasound (USG) guidance in patients with supraspinatus tear.

MATERIALS AND METHODS

Twenty-eight patients were divided into two groups: Group A (physiotherapy, n = 15) and Group B (PRP injection with USG guidance, n = 13). Pain (Visual Analog Score [VAS]) and function (Oxford Shoulder Score [OSS]) were evaluated at baseline, 1 week, 4 weeks, and 12 weeks.

RESULTS

28 patients were divided into two groups, i.e., Group A (15 pt) - physiotherapy and Group B (13 pt) - PRP injection. On the basis of the VAS, PRP group has better score at 1 and 4 weeks as the results were statistically significant while insignificant at 12 weeks. On the basis of OSS, PRP group has better score at 1 and 4 weeks as the results were statistically significant while insignificant at 12 weeks similar to VAS score.

DISCUSSION

The findings on pain relief (VAS) generally agree that both methods offer short-term improvement, with PRP potentially having a slight edge. However, the long-term effects (beyond 3 months) are less clear. Similarly, physiotherapy shows promise in improving function (Oxford score) in the short term, while some PRP studies suggest sustained benefits, possibly dependent on the specific PRP formulation. Overall, the discussion highlights the need for further investigation into the long-term efficacy of PRP compared to physiotherapy for managing rotator cuff tears.

CONCLUSION

Improvement in function and relief in pain were better in PRP group when compared to conservative group but we found that PRP has no superior result as compared to conservative therapy in the management of rotator cuff tear.

摘要

引言

冈上肌腱病是肩部疼痛的常见原因,伴或不伴有相关的肩袖撕裂。文献中描述了多种治疗方式,如物理治疗、镇痛药、皮质类固醇注射、手术修复(开放或关节镜)以及富血小板血浆(PRP)注射。最近,PRP注射治疗肩袖关节病的趋势日益增加。因此,我们进行了一项研究,以评估超声(USG)引导下PRP注射对冈上肌撕裂患者的有效性。

材料与方法

28例患者分为两组:A组(物理治疗,n = 15)和B组(USG引导下PRP注射,n = 13)。在基线、1周、4周和12周时评估疼痛(视觉模拟评分[VAS])和功能(牛津肩评分[OSS])。

结果

28例患者分为两组,即A组(15例)——物理治疗和B组(13例)——PRP注射。基于VAS,PRP组在1周和4周时得分更高,结果具有统计学意义,而在12周时无统计学意义。基于OSS,PRP组在1周和4周时得分更高,结果具有统计学意义,与VAS评分相似,在12周时无统计学意义。

讨论

关于疼痛缓解(VAS)的研究结果总体上一致认为,两种方法都能带来短期改善,PRP可能略有优势。然而,长期效果(超过3个月)尚不清楚。同样,物理治疗在短期内显示出改善功能(牛津评分)的前景,而一些PRP研究表明有持续的益处,这可能取决于特定的PRP配方。总体而言,讨论强调了与物理治疗相比,需要进一步研究PRP治疗肩袖撕裂的长期疗效。

结论

与保守组相比,PRP组在功能改善和疼痛缓解方面更好,但我们发现,在肩袖撕裂的治疗中,PRP与保守治疗相比没有更好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14dc/11632504/00bba34dd7cc/JOCR-14-257-g001.jpg

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