OUTCOMES OF PRP INJECTION THERAPY IN SUBACROMIAL SPACE IN PARTIAL TEARS OF ROTATOR CUFF

HARMANPREET SINGH; SAHIL VERMA; KSHITIJ MEHTA; DALJINDER SINGH; DHARMINDER SINGH; GIRISH SAHNI; SIMRAN

doi:10.22159/ajpcr.2024v17i7.50682

Authors

HARMANPREET SINGH Department of Orthopedics, GMC and Rajindra Hospital, Patiala, Punjab, India https://orcid.org/0009-0008-4298-9220
SAHIL VERMA Department of Orthopedics, GMC and Rajindra Hospital, Patiala, Punjab, India
KSHITIJ MEHTA Department of Orthopedics, GMC and Rajindra Hospital, Patiala, Punjab, India
DALJINDER SINGH
DHARMINDER SINGH Department of Orthopedics, GMC and Rajindra Hospital, Patiala, Punjab, India.
GIRISH SAHNI Department of Orthopedics, GMC and Rajindra Hospital, Patiala, Punjab, India
SIMRAN Department of Dermatology and Venerology, GMC and Rajindra Hospital, Patiala, Punjab

DOI:

https://doi.org/10.22159/ajpcr.2024v17i7.50682

Keywords:

Original research . First author has been mistakenly written twice . Kindly rectify that . Thanks and regards for same.

Abstract

Objective: The aim of the study was to record therapy in the subacromial area in cases of partial rotator cuff (RC) tears on controlling pain and improving shoulder mobility and performing daily activities with ease.

Methods: The study was conducted in the Orthopedics branch of Government Medical College and Rajindra Hospital Patiala on a total of 50 patients (aged more than 20 years) who presented in the emergency and Outpatient Department with symptoms of anterolateral shoulder pain and decreased range of motion at shoulder joint, who had not responded to conservative management and physiotherapy measures for consecutive 3 months. The patients were subjected to magnetic resonance imaging of the affected shoulder and those who showed partial cuff tears were considered for the study. Every consenting patient was given a PRP injection by posterior approach into the subacromial space. Patients were then followed up subsequently after 1 month, 6 months, 12 months, and 24 months for resolution of symptoms and improved painless activities at the shoulder. The outcome was assessed based on Visual Analog Scale (VAS) system and constant shoulder scoring system.

Results: Comparison of the patients before and after injection therapy revealed a significant difference in VAS and constant shoulder scale at all the follow-up times with maximum improvement at the longest follow-up period.

Conclusion: Injection of PRP in subacromial space was found safe and effective in enhancing overall life quality with the betterment of symptoms in patients with anterolateral shoulder pain, and thus, improving efficiency of work, shoulder functioning in patients having partial RC tears irrespective of its cause with its beneficial effects more at long term.

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References

van der Windt DA, Koes BW, de Jong BA, Bouter LM. Shoulder disorders in general practice: Incidence, patient characteristics, and management. Ann Rheum Dis 1995;54:959-64.

Anitua E, Andía I, Sanchez M, Azofra J, del Mar Zalduendo M, de la Fuente M, et al. Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res 2005;23:281-6.

Piper CC, Hughes AJ, Ma Y, Wang H, Neviaser AS. Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2018; 27(3):572–6.

de Sanctis EG, Franceschetti E, De Dona F, Palumbo A, Paciotti M, Franceschi F. The Efficacy of Injections for Partial Rotator Cuff Tears: A Systematic Review. J Clin Med. 2020;10(1):51.

Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;254:64–74.

Weber S. Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial thickness rotator cuff tears. Arthroscopy: the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 1999;15(2):126–31.

Ide J, Maeda S, Takagi K. Arthroscopic transtendon repair of partial-thickness articular-side tears of the rotator cuff: anatomical and clinical study. Am J Sports Med. 2005;33(11):1672–9.

Jordan RW, Bentick K, Saithna A. Transtendinous Repair of Partial Articular Sided Supraspinatus Tears Is Associated With Higher Rates of Stiffness and Significantly Inferior Early Functional Scores Than Tear Completion and Repair: A Systematic Review Orthop Traumatol Surg Res. 2018;104(6):829–37.

Shin S. A comparison of 2 repair techniques for partial-thickness articularsided rotator cuff tears. Arthroscopy: the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2012;28:25–33.

Unverferth LJ, Olix ML. The effect of local steroid injections on tendon. The Journal of sports medicine. 1973;1(4):31–7.

Chechick A, Amit Y, Israeli A, Horoszowski H. Recurrent rupture of the achilles tendon induced by corticosteroid injection. Br J Sports Med. 1982; 16(2):89.

Ramírez J, Pomés I, Cabrera S, Pomés J, Sanmartí R, Cañete JD. Incidence of Full-Thickness Rotator Cuff Tear After Subacromial Corticosteroid Injection: A 12-week Prospective Study. Mod Rheumatol. 2014;24(4):667–70.

Andriolo L, Altamura SA, Reale D, Candrian C, Zaffagnini S, Filardo G. Nonsurgical Treatments of Patellar Tendinopathy: Multiple Injections of Platelet-Rich Plasma Are a Suitable Option: A Systematic Review and Metaanalysis. Am J Sports Med. 2019;47(4):1001–18.

Cai YU, Sun Z, Liao B, Song Z, Xiao T, Zhu P. Sodium Hyaluronate and Platelet-Rich Plasma for Partial-Thickness Rotator Cuff Tears. Med Sci Sports Exerc. 2019;51(2):227–33.

Ilhanli I, Guder N, Gul M. Platelet-Rich Plasma Treatment With Physical Therapy in Chronic Partial Supraspinatus Tears. Iran Red Crescent Med J. 2015;17(9):e23732.

Jo CH, Lee SY, Yoon KS, Oh S, Shin S. Allogenic Pure Platelet-Rich Plasma Therapy for Rotator Cuff Disease: A Bench and Bed Study. Am J Sports Med. 2018;46(13):3142–54.

Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013; 41(11):2609–16.

Mautner K, Colberg RE, Malanga G, Borg-Stein JP, Harmon KG, Dharamsi AS, et al. Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review. Pm r. 2013;5(3): 169–75.

Rha DW, Park GY, Kim YK, Kim MT, Lee SC. Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial. Clin Rehabil. 2013;27(2): 113–22.

Sari A, Eroglu A. Comparison of ultrasound-guided platelet-rich plasma, prolotherapy, and corticosteroid injections in rotator cuff lesions. J Back Musculoskelet Rehabil. 2020;33(3):387–96.

Say F, Gurler D, Bulbul M. Platelet-rich Plasma Versus Steroid Injection for Subacromial Impingement Syndrome. J Orthop Surg (Hong Kong). 2016; 24(1):62–6.

Scarpone M, Rabago D, Snell E, Demeo P, Ruppert K, Pritchard P, et al. Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study. Glob Adv Health Med. 2013;2(2):26–31.

Shams A, El-Sayed M, Gamal O, Ewes W. Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears. Eur J Orthop Surg Traumatol 2016;26:837-42.

Edoardo Giovannetti de Sanctis, Edoardo Franceshetti Ferninando De Dona, Alessio Palumbo . The efficacy of injection for partial rotator cuff Tears:A systematic review . J Clin Med 2021,10,51 dx .doi.org/10.3390/jcm10010051

Pengfei ZHV Zhengchao WANG Hongmei LI Yu CAI doi:10.2340/jrm.v54.1434 thu, 15Sep 2022 in Journal of rehabilitation Medicine.