Effect of platelet-rich plasma on the degenerative rotator cuff tendinopathy according to the compositions
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(2019) 14:408
RESEARCH ARTICLE
Open Access
Effect of platelet-rich plasma on the degenerative rotator cuff tendinopathy according to the compositions Sang Jun Kim1* , Seung Mi Yeo2, Soo Jin Noh2, Chul-Won Ha3, Byung Chan Lee2, Hyo Sun Lee2 and Sun Jeong Kim2
Abstract Background: There are controversies about platelet-rich plasma (PRP) as an established treatment option for rotator cuff (RC) tendinopathy. The purpose of the study was to find the relation of cellular component with clinical efficacy in RC tendinopathy and to find the composition of PRP in treating RC tendinopathy. Methods: A total 30 patients were recruited and divided into PRP and control groups. In the PRP group, 2 ml of PRP solution was injected to the hypoechoic lesion of degenerative supraspinatus via 22-gauge syringe with peppering technique. Patients in the control group were taught rotator cuff strengthening exercises. American Shoulder and Elbow Surgeons (ASES), Constant-Murley score, and numeric rating scale (NRS) were measured before, 6 weeks after, 12 weeks after, and 24 weeks after the procedure. PRP compositions were analyzed using the 1 ml of PRP solution. Results: Linear regression analysis showed no significant difference of ASES and Constant-Murley scores between the groups at 6 weeks (P = 0.582 and 0.258) and at 12 weeks (P = 0.969 and 0.795) but showed a significant difference at 24 weeks (P = 0.050 and 0.048). Independent t test showed significant group difference of NRS at 6 weeks (P = 0.031) but not at 12 and 24 weeks (P = 0.147 and 0.935). 5.19 pg/ml in IL-1β and 61.79 μg/ml in TGF-β1 were acquired as cutoff values to predict meaningful improvement. The PRP subgroup above IL-1β or TGF-β1 cutoff value showed significant differences in all clinical outcomes compared with the exercise group while the PRP subgroup below the cutoff value showed no significant differences in linear regression analysis. Conclusions: Our study can help to find the optimal PRP condition and to enhance the effect of PRP on RC tendinopathy. Trial registration: All the patients were registered in our Institutional Ethics Committee (approval number 2014-05-009). Keywords: Platelet-rich plasma, Rotator cuff, Exercise, Growth factors, Shoulder function
Introduction Rotator cuff (RC) tendinopathy is a degenerative musculoskeletal disease caused by overuse. The prevalence of RC disease, specifically partial and full thickness RC tendon tears, increases as a function of age starting at 40 years [1] and may be high as 50% by the age of 70 years [2]. Conservative treatments for RC tendinopathy include exercise, medication, and injection therapy. Medication * Correspondence: [email protected] 1 Seoul Jun Rehabilitation Research Center, Seoul Jun Rehabilitation Medical Center, Nambusoonhwanro, 2606, Seoul 06737, South Korea Full list of author information is available at the end of the article
and steroid injection therapy only help to reduce the pain, but exercise is effective as a treatment for regaining function in addition to reduction of pain in RC
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