|ECR 2019 / C-1482|
|Ultrasound-guided platelet rich plasma (PRP) injection insupraspinatus tendon partial tear: more to explore|
Aims and objectives
Supraspinatus tendon is part of the rotator cuff of the shoulder and it is responsible for abduction of the upper limb(1).A tear or rupture of the tendon of the supraspinatus muscle can occur in 2 ways; either partial or full thickness tear and most of the time it is accompanied with another rotator cuff muscle tear but it is the most commonly injured(2).A partial tear means that the tendon fibers will not be completely disrupted yet a complete tear is the disruption of all tendon fibers.
Rotator cuff tears have a reported incidence of greater than 50% among the adult population(3) and are associated with significant functional limitation commonly caused by supraspinatus muscle. The most common risk factors for such cases are: above 40 years of age, overweight, repetitive lifting or overhead activities, certain jobs like; Tennis players, baseball pitchers, painters, carpenters and traumatic injury (most common in young people) (4).
Diagnosis of the muscle tears is based on: history, clinical examination, and imaging using X Rays, CT scanning, MRI and ultrasonography. The role of imaging is to guide treatment decision(6). The diagnosis of rotator cuff injury, tendinopathy, partial or full thickness tear, and its extent can determine whether the patient will undergo surgery or just will be managed conservatively(5,7). Also, the surgical approach, open versus arthroscopic, is chosen based on the imaging diagnosis(7,8).
Recently, there has been growing interest in the area of biological therapies to assist musculoskeletal repair. Autologous platelet-rich plasma (PRP) is one such therapy that has gained much attention Platelet-rich plasma is a volume of the plasma fraction of whole blood having a platelet concentration above that of the baseline, it has the ability to promote connective tissue development and regeneration through multiple mechanisms(9). Despite increased use of PRP in treatment of tendinopathy; few studies have searched the value of PRP injection in cases of supraspinatus tendon partial thickness tear and trials on the use of PRP in tendon pathology have been inconclusive(10,11).
Accordingly, our study efforts sought assessment of the role of ultrasound guided PRP injection in supraspinatus tendon partial thickness tear.
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