Purpose
The degenerative diseases of the shoulder are non-surgically treated today with drugs and physical therapies to obtain pain relief.
The injection of platelet-rich plasma is employed as a therapy to reduce pain on the basis of its anti-inflammatory and tissue regeneration effects that help to recover functionality.
Evaluate the efficacy of the treatment of supraspinatus tendinosis with ultrasound guided injection of platelet rich plasma.
PRP is a haemocomponent produced through separation of the whole blood.
The use of this haemocomponent,
despite having been documented in...
Methods and Materials
We evaluated ninety-two patients with tendinosis of supraspinatus tendon.
The instrumental evaluation was based on US and MRI.
In particular,
the morphological recovery of the lesions after treatment was assessed by independent review of MR images performed by three radiologists.
Our protocol included three US-guided infiltrations at a distance of 21 days between each other,
preceded by clinical,
functional and US assessments.
The patients were evaluated from both the clinical and functional points of view by VAS and Constant Scale.
Results
The MRI control was performed both before treatment and 30 days after the last infiltration.
The mean VAS at the end of treatment improved from 6.75 to 1.8), the Constant scale from 55.7 to 85.5.
In fifty-nine patients (78/92 84.7%),
post procedural MRI control showed disappearance of inflammatory signs.
Tendon thickness,
evaluated on MRI,
results decreased in 45/92 (48.9%) cases by 5-15%.
We observed a partial or complete morphological changes of MRI signal in 61/92 (66%).
Conclusion
The main limitations of this study,
represented by a relatively small population of patients and short-term,
though encouraging,
results,
did not prevent us from drawing a positive opinion about the effectiveness of autologous PRP in the ultrasound-guided,
infiltrative treatment of the degenerative pathology of the supraspinatus tendon.
Further studies on a larger and more homogeneous population are needed to confirm our results.
The clinical and functional results,
that showed a valid response to the treatment in almost all cases,
suggest that PRP can be employed...
References
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(2) Wang H.
and Avila G.
Platelet rich plasma: Myth or Reality? 2007 European Journal of Dentistry.
(3) Giusti I,
Rughetti A,
D’Ascenzo S.
et al.
Identification of an optimal concentration of platelet gel for promoting angiogenesis in human endothelial cell.
Transfusion.
2009 Apr;49(4):771-8.
Epub 2008 Dec 23