Efficacy of Platelet-Rich Plasma for the Treatment of Interstitial Supraspinatus Tears: A Double-Blinded, Randomized Controlled Trial.

Détails

ID Serval
serval:BIB_3821C0329399
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Efficacy of Platelet-Rich Plasma for the Treatment of Interstitial Supraspinatus Tears: A Double-Blinded, Randomized Controlled Trial.
Périodique
The American journal of sports medicine
Auteur(s)
Schwitzguebel A.J., Kolo F.C., Tirefort J., Kourhani A., Nowak A., Gremeaux V., Saffarini M., Lädermann A.
ISSN
1552-3365 (Electronic)
ISSN-L
0363-5465
Statut éditorial
Publié
Date de publication
07/2019
Peer-reviewed
Oui
Volume
47
Numéro
8
Pages
1885-1892
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The benefits of platelet-rich plasma (PRP) for the treatment of rotator cuff tears remain inconclusive, as it is administered either as an adjuvant to surgical repair or as a primary infiltration without targeting the index lesion, which could dilute its effect.
To determine whether PRP infiltrations are superior to saline solution infiltrations (placebo) at improving healing, pain, and function when injected under ultrasound guidance within isolated interstitial supraspinatus tears.
Randomized controlled trial; Level of evidence, 1.
In this single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic isolated interstitial tears of the supraspinatus, confirmed by magnetic resonance arthrography, were randomized to PRP or saline injections. Each patient received 2 injections with a 1-month interval. The primary outcome was the change in lesion volume, calculated on magnetic resonance arthrography, at 7 months. The secondary outcomes were improvements in shoulder pain and the Single Assessment Numerical Evaluation (SANE) score at >12 months.
Preoperative patient characteristics did not differ between the 2 groups. At 7 months, there were no significant differences between the PRP and control groups in terms of a decrease in lesion size (-0.3 ± 23.6 mm <sup>3</sup> vs -8.1 ± 84.7 mm <sup>3</sup> , respectively; P = .175); reduction of pain on a visual analog scale (VAS) (-2.3 ± 3.0 vs -2.0 ± 3.0, respectively; P = .586); and improvement in SANE (16.7 ± 20.0 vs 14.9 ± 29.0, respectively; P = .650), Constant (8.6 ± 13.0 vs 10.7 ± 19.0, respectively; P = .596), and American Shoulder and Elbow Surgeons (19.5 ± 20.0 vs 21.9 ± 28.0, respectively; P = .665) scores. At >12 months, there were no significant differences between the PRP and control groups in terms of a reduction of pain on a VAS (-3.3 ± 2.6 vs -2.3 ± 3.2, respectively; P = .087) or improvement in the SANE score (24.4 ± 27.5 vs 23.4 ± 24.9, respectively; P = .846). At 19.5 ± 5.3 months, the incidence of adverse effects (pain >48 hours, frozen shoulder, extension of lesion) was significantly higher in the PRP group than the control group (54% vs 26%, respectively; P = .020).
PRP injections within interstitial supraspinatus tears did not improve tendon healing or clinical scores compared with saline injections and were associated with more adverse events.
NCT02672085 (ClinicalTrials.gov identifier).
Mots-clé
inflammation, tendinitis, treatment, ultrasonography
Pubmed
Web of science
Création de la notice
17/06/2019 16:25
Dernière modification de la notice
21/08/2019 5:37
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