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Orthop Traumatol Surg Res ; 102(8): 977-982, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-28341267

RESUMO

BACKGROUND: Rotator cuff tear (RCT) is a frequent condition of clinical relevance that can be managed with a symptomatic conservative treatment, but surgery is often needed. Biological components like leukocytes and platelet rich plasma (L-PRP) could represent an alternative curative method for interstitial RCT. HYPOTHESES: It has been hypothesized that an ultrasound guided L-PRP injection in supraspinatus interstitial RCT could induce radiological healing. MATERIAL AND METHODS: A prospective case series including 25 patients was performed in order to assess the effect of L-PRP infiltration into supraspinatus interstitial RCTs. Primary outcome was tear size change determined by magnetic resonance imaging arthrogram (MRA) before and 6 months after L-PRP infiltration. Secondary outcomes were Constant score, SANE score, and pain visual analog scale (VAS) after L-PRP infiltration. RESULTS: Tear volume diminution was statistically significant (P=.007), and a >50% tear volume diminution was observed in 15 patients. A statistically significant improvement of Constant score (P<.001), SANE score (P=.001), and VAS (P<.001) was observed. In 21 patients, Constant score improvement reached the minimal clinical important difference of 10.4 points. DISCUSSION: We observed a statistically significant and clinically relevant effect on RCT size and clinical parameters after L-PRP infiltration. Such an important improvement of supraspinatus interstitial RCT with conservative management is uncommon, therefore intratendinous L-PRP infiltrations could have been beneficial. This encouraging result could pave the way for future randomized studies in order to formally determinate whether L-PRP infiltrations are a possible alternative to surgical treatment of interstitial RCT. LEVEL OF EVIDENCE: Prospective observational study; Level of evidence II.


Assuntos
Plasma Rico em Plaquetas , Lesões do Manguito Rotador/terapia , Cicatrização , Adolescente , Adulto , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Radiografia , Lesões do Manguito Rotador/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
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