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肩峰下滑囊干细胞疗法联合富血小板血浆与关节镜下肩袖修补术可减轻术后疼痛并改善功能结局:一项回顾性研究。

Combined Subacromial Bursal Stem Cell Therapy and Platelet-Rich Plasma Alongside Arthroscopic Rotator Cuff Surgery Reduces Postoperative Pain and Improves Functional Outcomes: A Retrospective Study.

作者信息

Miškulin Mladen, Savić Josip, Dulić Oliver, Dragaš Emili, Košec Andro

机构信息

Special Hospital Arithera, 10000 Zagreb, Croatia.

Clinical Center of Vojvodina, Medical Faculty, University of Novi Sad, 21000 Novi Sad, Serbia.

出版信息

J Clin Med. 2025 Aug 7;14(15):5590. doi: 10.3390/jcm14155590.

Abstract

: This study investigates the benefits of incorporating stem cell therapy into arthroscopic rotator cuff repair by evaluating its impact on postoperative pain and functional recovery. : A retrospective, comparative analysis was conducted with a small cohort of patients undergoing rotator cuff surgery, divided into two groups: one receiving adjunctive combined PRP and bursal stem cell therapy and the other undergoing standard arthroscopic repair alone. The outcomes were assessed using visual analog scale (VAS) scores for pain and the Constant-Murley score (CMS), which includes strength of abduction, VAS pain, limitation and range of motion, evaluated at baseline, 1, 2, 3 and 6 months postoperatively. : Patients in the stem cell group experienced significantly greater reductions in pain scores and more substantial improvements in functional scores at the follow-up points compared to the control group. A linear mixed-effects analysis showed that in the early postoperative period, the use of PRP and bursal stem cell therapy was associated with significantly reduced postoperative VAS pain scores (F 4.8, = 0.045) and an increased CMS regarding postoperative pain (F 8.6, = 0.01), alongside painless elevation level (F 6.5, = 0.022), forward flexion (F 8.5, = 0.01) and abduction scores (F 8.3, = 0.011). The effect of PRP and bursal stem cell therapy remains constant during late follow-up, from the fourth to sixth postoperative month, with postoperative CMS regarding pain remaining statistically significantly higher in the stem cell therapy group (F 4.8, = 0.008), alongside reduced night-time pain (F 7.4, = 0.015), improved recreation ability (F 4.8, = 0.044) and reduced activity restriction (F 5.8, = 0.028). : The findings suggest that the addition of stem cell therapy to arthroscopic rotator cuff repair may enhance postoperative recovery by alleviating pain and promoting functional gains.

摘要

本研究通过评估干细胞疗法对术后疼痛和功能恢复的影响,探讨将其纳入关节镜下肩袖修复术的益处。

对一小群接受肩袖手术的患者进行了回顾性比较分析,分为两组:一组接受辅助性联合富血小板血浆(PRP)和滑囊干细胞疗法,另一组仅接受标准关节镜修复术。使用视觉模拟量表(VAS)疼痛评分和Constant-Murley评分(CMS)评估结果,CMS包括外展力量、VAS疼痛、活动受限和活动范围,在基线、术后1、2、3和6个月进行评估。

与对照组相比,干细胞组患者在随访时疼痛评分显著降低,功能评分有更显著改善。线性混合效应分析表明,在术后早期,使用PRP和滑囊干细胞疗法与术后VAS疼痛评分显著降低(F = 4.8,P = 0.045)以及术后疼痛方面的CMS增加(F = 8.6,P = 0.01)相关,同时无痛抬高水平(F = 6.5,P = 0.022)、前屈(F = 8.5,P = 0.01)和外展评分(F = 8.3,P = 0.011)也有所增加。在术后晚期随访(术后第四至第六个月),PRP和滑囊干细胞疗法的效果保持不变,干细胞治疗组术后疼痛方面的CMS在统计学上仍显著更高(F = 4.8,P = 0.008),同时夜间疼痛减轻(F = 7.4,P = 0.015)、娱乐能力改善(F = 4.8,P = 0.044)和活动受限减少(F = 5.8,P = 0.028)。

研究结果表明,在关节镜下肩袖修复术中添加干细胞疗法可能通过减轻疼痛和促进功能恢复来增强术后恢复。

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