Four years of clinical and MRI follow-up after intratendinous US-guided platelet rich plasma (PRP) injection in patients with degenerative tendinopathy of rotator cuff tendons of the shoulder

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Congress:

ECR 2015

Poster Number:

B-0072

Type:

Scientific Paper

Keywords:

Interventional non-vascular, Musculoskeletal joint, Ultrasound, Puncture, Image verification

Authors:

F. Arrigoni, A. La Marra, S. Mariani, L. M. Gregori, L. Zugaro, A. Barile, C. Masciocchi; L'Aquila/IT

DOI:

10.1594/ecr2015/B-0072

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/B-0072

Fig. 2

Fig. 1

Fig. 3: Case 1: Coronal and Sagittal imaging of a patient treated with PRP with an...

Fig. 4: Case 2: patient with an imaging that remained substantially unmodified 4 years...

Purpose

To evaluate the evolution of degenerative tendinopathy of the rotator cuff from the morphological (MRI images) and clinical point of view 4 years after treatment with US-guided PRP injection of the supraspinatus tendon, compared with patients submitted to medical and physical therapy alone.

Methods and materials

We retrospectively evaluated 240 patients without history of trauma or surgery before the treatment and during the follow-up. One hundred andtwenty were treated 4 years before with US-guided PRP injection of the supraspinatus tendon (group 1, G1); 120 were submitted, over a 4 year period, to medical and physical therapy alone (group 2, G2). Two radiologists independently evaluated the MRI performed before and 4 years after the PRP injection (G1) or, in the G2, 2 MRIs performed before and after 4 years of physical and...

Results

We recorded an improvement in the MRI appearance of the supraspinatus tendon in 31.7% of the G1 and only in 3.3% of G2. Stationary findings were found in 48.3% (G1) and 34.2% (G2) of patients. In the 20% (G1) and 62% (G2) of patients were described a worsening of the imaging findings. About the clinical results, this is the mean VAS improvement: 74.5% (G1) and 16.2% (G2); mean Constant improvement 56% (G1) and 9% (G2).

Conclusion

The results of this study suggest that intratendinous injection of PRP can modify the natural history of the rotator cuff tendinopathy compared to the Medical and Physical therapies PRP injection infact can delay the degenerative changes of the tendons and this is documented by the pain relief and functional improvement. MRI imaging findings are an important evidence of the effectiveness of this therapy, because they confirm the clinical evidence. In this study we can finc some limits: 1) Patients were not divided by age 2)...

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References

-Kesikburun, S. et al. (2013).Platelet-rich plasmainjections in the treatment ofchronic rotatorcufftendinopathy: arandomizedcontrolled trial with 1-year follow-up. The American Journal of Sports Medicine -Effectiveness of platelet-rich plasma Injection for rotator cuff tendinopathy: a prospective Open-label study Scarpone M. et al. Glob Adv Health Med. 2013 Mar