SYSTEMATIC REVIEW WITH NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS OF ROTATOR CUFF TEAR TREATMENT

2018 ◽  
Vol 34 (1) ◽  
pp. 78-86 ◽  
Author(s):  
Seihee Kim ◽  
Jinseub Hwang ◽  
Min Jee Kim ◽  
Jae-Young Lim ◽  
Woo Hyung Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Open Surgery ◽  
Randomized Clinical Trials ◽  
Structural Integrity ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Functional Improvement ◽  
Cuff Tear

Objectives:Rotator cuff tear is the leading cause of the decline in quality of life for older adults, but comparative evidence on treatment effectiveness is lacking. This study systematically reviewed the effects of various rotator cuff tear treatments through a Bayesian meta-analysis of the related randomized clinical trials (RCTs).Methods:We searched nine electronic databases for RCTs evaluating rotator cuff tear treatments from their inception through June 2017. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the National Institute for Health and Care Excellence-Decision Support Unit guidelines (Supplementary Table 1). Outcomes included functional improvement, pain one year after surgical treatment, and tendon structural integrity. The Bayesian network meta-analysis was applied for functional improvement and pain, based on an assumption of consistency and similarity. Tendon integrity was reported descriptively.Results:Fifteen RCTs were selected. Patients undergoing physiotherapy after open surgery showed statistically significant functional improvements compared with those undergoing physiotherapy only (mean differences, 9.1 [credible interval, 0.9–17.4]). Open surgery with physiotherapy was associated with a decrease in pain 1 year after treatment compared with when physiotherapy was combined with arthroscopic rotator cuff surgery, mini open surgery, platelet-rich plasma therapy, or physiotherapy alone (absolute value of mean difference 1.2 to 1.4). The tendon integrity results were inconsistent.Conclusions:Some surgical treatments were associated with significant improvement in function and pain, but evidence regarding their comparative effectiveness is still lacking. A well-designed RCT discussing functional and structural treatment outcomes is needed in future.

Acromion morphology and prevalence of rotator cuff tear: A systematic review and meta-analysis

2018 ◽  
Vol 32 (1) ◽  
pp. 122-130 ◽  
Author(s):  
Kimberly M. Morelli ◽  
Bradley R. Martin ◽  
Fatima H. Charakla ◽  
Anel Durmisevic ◽  
Gordon L. Warren
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Meta Analysis ◽  
Cuff Tear

scholarly journals Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review

2020 ◽  
pp. 1-16
Author(s):  
David M. Robinson ◽  
Christine Eng ◽  
Steven Makovitch ◽  
Joshua B. Rothenberg ◽  
Stephanie DeLuca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Cohort Studies ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Inclusion Criteria ◽  
Serious Adverse Events ◽  
Bias Risk ◽  
Glenohumeral Osteoarthritis ◽  
Functional Outcome Measures

BACKGROUND: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed “low risk of bias or good quality”. Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.

scholarly journals Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma

2017 ◽  
Vol 7 ◽  
pp. 32 ◽  
Author(s):  
Vetrivel Chezian Sengodan ◽  
Sajith Kurian ◽  
Raghupathy Ramasamy
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Platelet Rich Plasma ◽  
Rotator Cuff Tears ◽  
Lateral Side ◽  
Ultrasound Guided ◽  
Cuff Tear ◽  
Plasma Injection ◽  
Partial Rotator Cuff Tear ◽  
Shoulder Score

Background: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. Materials and Methods: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Results: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001) at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Conclusion: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.

scholarly journals Evaluation of animal models and methods for assessing shoulder function after rotator cuff tear: A systematic review

2021 ◽  
Vol 26 ◽  
pp. 31-38
Author(s):  
Yang Liu ◽  
Sai C. Fu ◽  
Hio T. Leong ◽  
Samuel Ka-Kin Ling ◽  
Joo H. Oh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Animal Models ◽  
Rotator Cuff Tear ◽  
Shoulder Function ◽  
Cuff Tear

scholarly journals Platelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection

2020 ◽  
Vol 28 (1) ◽  
pp. 230949901988766 ◽  
Author(s):  
Qipeng Wu ◽  
Xuefen Luo ◽  
Yuan Xiong ◽  
Guohui Liu ◽  
Junwen Wang ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
International Knee Documentation Committee ◽  
Joint Disease ◽  
Functional Improvement ◽  
Current Evidence ◽  
Cochrane Library

Osteoarthritis (OA) is an extremely common form of chronic joint disease which can affect the knees and other joints of older adults, leading to debilitating disability in the knee and consequent reduction in quality of life. Intra-articular platelet-rich plasma (PRP) or hyaluronic acid (HA) injections are effective for maintaining long-term beneficial effects without increasing the risk of intra-articular infection. However, few studies have compared the relative value of HA and PRP for OA treatment. PRP is more effective than HA for OA treatment in recent studies of this topic. We systematically searched Medline, SpringerLink, Embase, Pubmed, Clinical Trials.gov, the Cochrane Library, and OVID for all articles published through May 2018. Any study was included that compared the effect of HA and PRP (consistent treatment cycle and frequency of injection) on patient’s pain levels and functionality improvements. Review Manager 5.3 was used to analyze data regarding these two primary outcomes. We included 10 total studies in the present meta-analysis. International Knee Documentation Committee (IKDC; MD: 10.37, 95% confidence interval (CI): 9.13 to 11.62, p < 0.00001), Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC; MD: −20.69, 95% CI: −24.50 to −16.89, p < 0.00001, I2 = 94%), and Visual Analogue Scale (VAS; MD: −1.50, 95% CI: −1.61 to −1.38, p < 0.00001, I2 = 90%) differed significantly between the PRP and HA groups. Knee Osteoarthritis Outcome Scores (KOOSs) did not differ significantly ( χ2 = 23.53, I2 = 41%, p = 0.11). Our hypothesis appears not to be confirmed because PRP and HA did not differ significantly with respect to KOOS score. However, the IKDC, WOMAC, and VAS scores differed significantly. Thus, based on the current evidence, PRP appears to be better than HA at achieving pain relief and self-reported functional improvement. Ia, meta-analyses of randomized clinical trials.

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