Effect of platelet-rich plasma treatment for partial rotator cuff injury and possible mechanism
10.3760/cma.j.cn501098-20211104-00570
- VernacularTitle:富血小板血浆治疗部分肩袖损伤的疗效及可能机制
- Author:
Zhixing XUE
1
;
Panfeng YU
;
Shu ZHANG
;
Cheng CHI
;
Jianwei ZHOU
Author Information
1. 首都医科大学附属北京同仁医院骨科，北京 100730
- Keywords:
Shoulder;
Rotator cuff injuries;
Platelet-rich plasma
- From:
Chinese Journal of Trauma
2022;38(4):314-319
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of platelet-rich plasma (PRP) injection and conventional treatment for partial rotator cuff tear and analyze the possible mechanism.Methods:A prospective randomize control study was performed for clinical data of 100 patients with partial rotator cuff tear admitted to Beijing Tongren Hospital affiliated to Capital Medical University between January 2019 and December 2020. The patients were assigned to observation group ( n=50) and control group ( n=50) according to the random number table. Both groups were given conventional non-operative treatment, together with PRP injection in observation group and steroid injection in control group. The visual analogue score (VAS), Constant-Murley Score (CMS) and serum levels of inflammatory cytokines [interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α)] were measured before and at 3, 6 months after treatment. The MRI images were also evaluated in observation group before treatment and at 6 months after treatment. Results:There were 55 males and 45 females with the age range of 40-75 years [(55.9±9.1)years]. All patients were followed up for 6.0-8.2 months [(6.2±2.9)months]. There were no significant differences between the two groups in VAS, CMS, IL-6, IL-1β and TNF-α before treatment (all P>0.05). The VAS was (3.5±0.9)points and (1.4±0.4)points] in observation group at 3, 6 months after treatment, significant lower than (4.1±0.9)points and (1.8±0.5)points in control group (all P<0.01). The CMS was (59.5±9.4)points and (86.5±7.9)points in observation group at 3, 6 months after treatment, significant higher than (53.5±8.6)points and (78.5±8.4)points in control group (all P<0.01). The serum levels of IL-6, IL-1β and TNF-α were (0.69±0.21)μg/L, (2.06±0.55)μg/L and (2.12±0.49)μg/L in observation group at 3 months after treatment, significant lower than (0.92±0.26)μg/L, (2.67±0.48)μg/L and (2.87±0.51)μg/L in control group (all P<0.01). The serum levels of IL-6, IL-1β and TNF-α in observation group [(0.37±0.11)μg/L, (1.14±0.23)μg/L, (1.27±0.25)μg/L] were also significantly lower than those in control group [(0.45±0.09)μg/L, (1.36±0.27)μg/L, (1.88±0.26)μg/L] at 6 months after treatment (all P<0.01). In both groups, the VAS, CMS and inflammatory cytokines (IL-6, IL-1β, TNF-α) showed significant improvement at 3, 6 months after treatment when compared to the pre-treatment levels (all P<0.05). Simutaneously, each group showed significant differences in each indicator at 3, 6 months after treatment ( P<0.05). In observation group, MRI showed that the high signal on the superior surface of the supraspinatus disappeared whereas the high signal in the tendon decreased at 6 months after treatment. Conclusion:For patients with partial rotator cuff tear, PRP injection can relive shoulder pain and improve shoulder function, which may be associated with the down-regulation of inflammatory responses.
