474 Effectiveness of Platelet Rich Plasma in the Treatment of Recalcitrant Shoulder Pathology

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H Hadi ◽  
O Asaad ◽  
M Kucera ◽  
G Arealis
Keyword(s):  
Steroid Injection ◽  
Platelet Rich Plasma ◽  
Patient Choice ◽  
Previous Surgery ◽  
Steroid Injections ◽  
Shoulder Pathology ◽  
Steroid Group ◽  
Group 2 ◽  
Lost To Follow Up

Abstract Aim To assess the outcome of platelet rich plasma injections (PRP) in patients with recalcitrant shoulder pathology using steroid injections as a control. Method This was a pragmatic retrospective analysis of patients treated for recalcitrant shoulder pathology between October 2018 to March 2019 with either PRP or steroid injection. Results In the PRP group 10 patients (n = 15) had previous steroid injections and 7 had previous surgery. 2 progressed to shoulder replacement. 5 have progressed to arthropathy. 4 patients were discharged due to improving symptoms. In the steroid group 2 patients (n = 15) were lost to follow up, 0 had previous surgery and 1 had a previous steroid injection. 6 were discharged due to improving symptoms. The average time to discharge post procedure was 241 days for PRP and 173 days for the steroid group. No complications were noted in either group. Conclusions Our findings show that PRP injections are a safe and effective treatment for cases of recalcitrant shoulder pathology leading to a 27% success rate for patients who have required steroid injections or arthroscopy in the past. In patients with arthropathy, PRP only has a short effect and should only be offered to patients that are unable to have surgery either due to high risk or patient choice. PRP requires a centrifuge machine and an operating theatre, thus incurring higher costs compared to steroid injections which may be given in clinic. Steroid injections should therefore remain the first line of treatment for recalcitrant shoulder pathology.

A Feasibility Study Comparing Platelet-Rich Plasma Injection With Saline for the Treatment of Plantar Fasciitis Using a Prospective, Randomized Trial Design

2018 ◽  
Vol 12 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Sarah Johnson-Lynn ◽  
Alan Cooney ◽  
Diarmaid Ferguson ◽  
Deborah Bunn ◽  
William Gray ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Resonance Imaging ◽  
Loss To Follow Up ◽  
Plasma Injection ◽  
Level Ii ◽  
Lost To Follow Up ◽  
And Control

Platelet-rich plasma (PRP) has been advocated for treatment of plantar fasciitis but there are few good-quality clinical trials to support its use. We conducted a feasibility study of PRP versus saline for treatment of plantar fasciitis. Patients with 6 months or more of magnetic resonance imaging–proven plantar fasciitis, who had failed conservative treatment were invited to participate in the study. Patients were block randomized to either PRP or an equivalent volume of saline. The techniques used for injection and rehabilitation were standardized for both groups. The patient and assessor were blinded. Visual analogue scale (VAS) for pain and painDETECT score were recorded preoperatively and at 6 months follow-up. From 35 patients approached, 28 (19 female, mean age 50 years) were recruited, with 14 randomized to each arm. At 6 months, 8 patients (28.6%) were lost to follow-up. There was a significant change in VAS score from baseline to follow-up in both intervention (mean change 37.2, P = .008) and control (mean change 42.2, P = .003) groups. There was no correlation between preoperative painDETECT score and change in VAS. Recruitment and loss to follow-up rates were relatively high. Both treatments resulted in a similar, significant, improvement in symptoms. Levels of Evidence: Level II

Intralesional steroids and endoscopic dilation for anastomotic strictures after esophagectomy: systematic review and meta-analysis

Endoscopy ◽  
2020 ◽  
Vol 52 (09) ◽  
pp. 721-726
Author(s):  
Chandra S. Dasari ◽  
Ramprasad Jegadeesan ◽  
Harsh K. Patel ◽  
Madhav Desai ◽  
Muhammad Aziz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Placebo Group ◽  
Steroid Injection ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Endoscopic Dilation ◽  
Steroid Group ◽  
Anastomotic Strictures ◽  
Local Steroid Injection

Abstract Background Post-esophagectomy anastomotic strictures are difficult to treat. The impact of adding local steroid injection to endoscopic dilation for the treatment of post-esophagectomy anastomotic strictures is unclear. We conducted a systematic review and meta-analysis to assess the efficacy of performing steroid injection in addition to dilation. Methods A search was conducted in MEDLINE, Cochrane Library, EMBASE, and Web of Science from inception to January 2019. Randomized controlled trials (RCTs) comparing the efficacy of endoscopic dilation plus either local steroid injection (steroid group) or saline injection (placebo group) were included in the analysis. Results Three RCTs were eligible for the final analysis: 72 patients (mean age 61.3 years, 74 % male) in the steroid group and 72 patients (mean age 59.6 years, 71 % male) in the placebo group. The mean number of dilations required to resolve the stricture was significantly lower in the steroid group compared with the placebo group, with a mean weighted difference of –1.62 (95 % confidence interval [CI] –2.73 to –0.50; P = 0.004). After 6 months of follow-up, there was a trend toward more patients in the steroid group remaining dysphagia free compared with the placebo group, with a pooled odds ratio of 2.36 (95 %CI 0.94 to 5.91; P = 0.07, I2  = 24 %). Conclusion This meta-analysis showed that the addition of local steroid injection at the time of dilation for benign anastomotic strictures led to a significant decrease in the number of procedures required to resolve the stricture and may well reduce dysphagia symptoms during follow-up.

scholarly journals Comparison of the clinical effect of intra-articular injection of platelet-rich plasma and methylprednisolone in primary osteoarthritis of knee: a randomized controlled trial

2019 ◽  
Vol 6 (6) ◽  
pp. 1842
Author(s):  
Darendrajit S. Longjam ◽  
Joy S. Akoijam ◽  
Meina S. Ahongshangbam ◽  
Nilachandra S. Longjam
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Osteoarthritis Of The Knee ◽  
Womac Pain ◽  
Osteoarthritis Of Knee ◽  
Primary Osteoarthritis ◽  
Steroid Group

Background: Osteoarthritis of knee is one of the commonest musculoskeletal disorder causing mobility impairment affecting 3.3% in urban areas and 5.5% in rural areas. Intra-articular injection of Platelet-Rich Plasma (PRP) delivers activated platelets that may reduce inflammation, provide pain relief, improve function and stimulate possible cartilage regeneration at the site of worn cartilage area of the knee.Methods: Eighty patients with primary osteoarthritis of the knee fulfilling inclusion and exclusion criteria were recruited in the study conducted in the Department of Physical Medicine and Rehabilitation, RIMS, Imphal from October 2014 to September 2017. Six ml of PRP prepared by conventional bench top centrifugation system was injected intra-articularly, two weeks apart in the PRP group. Steroid group received 80mg of methylprednisolone, two weeks apart by the same technique. The outcome variables (VAS and WOMAC score) were measured before starting intervention (baseline) and at 8 and 24-weeks post-intervention follow up.Results: Significant improvement seen in VAS, WOMAC-pain, stiffness and physical function and total scores in both the groups at 8- and 24-weeks follow-ups (p˂0.001). Steroid group showed better result than the PRP group in VAS (2.78±0.76 vs 3.58±1.03) and WOMAC-total (30.42±6.85 vs 36.25±10.87) scores at 8 weeks respectively (p˂0.001). But at 24 weeks follow-up, PRP showed significantly more effective than the steroid group in reducing pain (2.0±.0.87 vs 2.45±0.78) and disability (22.95±3.78 vs 25.25±6.67) respectively (p˂0.001).Conclusions: Intra-articular injection of methylprednisolone was found to be more effective in reducing pain and disability in primary knee osteoarthritis of KL grade 2 and 3 at the end of 8 weeks whereas 2 doses of PRP intra-articular injection 2 weeks apart was significantly more effective than methylprednisolone at the end of 24 weeks. However, the long-term benefit of PRP is to be determined by studies with a larger sample size and longer duration of follow-up.

scholarly journals 12-MONTHS RESULTS OF LEFT MAIN STENTING IN PATIENTS WITH HIGH SYNTAX SCORES

2019 ◽  
Vol 8 (1) ◽  
pp. 30-41
Author(s):  
D. P. Stolyarov ◽  
E. V. Sakhnov ◽  
A. V. Melnikov ◽  
I. N. Pligovka ◽  
E. V. Komarova ◽  
...  
Keyword(s):  
Composite Endpoint ◽  
Syntax Score ◽  
Mitral Insufficiency ◽  
Heart Team ◽  
Left Main ◽  
First Results ◽  
Group 2 ◽  
Lost To Follow Up ◽  
Group 1

Aim. To compare the safety and efficacy of stenting of the left main coronary artery (LMCA) in patients with moderate to high risks estimated with the SYNTAX score.Methods.112 patients with multivessel coronary disease and LMCA disease (SYNTAX score ≥23) and severe comorbidities were included in the study. All patients were deemed ineligible for CABG by the Heart Team. Patients were assigned to two groups according to the Syntax scores: Group 1 – patients with the SYNTAX scores of 23–32 (n = 66), and Group 2 patients with the SYNTAX scores of >32 (n = 46).Results.107 patients completed the 12-months follow-up. 5 patients in Group 1 and 2 patients in Group 2 were lost to follow up. Myocardial infarction (MI) (8.06% versus 13.33%, p = 0.37757) and heart mortality (6.45% versus 6.67%, p = 0.9646) cumulative rates were similar within the 12-month follow-up. There were no strokes or noncardiac deaths in both groups. The 12-month confirmed rate of stent thrombosis in Groups 1 and 2 did not differ statistically (3.23% vs. 6.67%, p = 0.4051). The unadjusted model (effects of variables on survival) reported that age (OR 1.15 (95% CI 1.05– 1.26), p = 0.0032), pulmonary hypertension (OR 1.05 (95% CI 1.01–1.09), p = 0.0111) and mitral insufficiency (OR 2.65 (95% CI 1.13–6.21), p = 0.0252) affected the composite endpoint. The adjusted model determined that only age affected the prognosis (OR 1.17 (95% CI 1.05–1.29), p = 0.0038).Conclusion.The first results of our study showed that stenting of LMCA in patients with moderate to high SYNTAX scores is a possible option and comparable with the 12-month follow-up. Age is as an independent predictor of future adverse events. Further evaluation of this complex patient cohort is required. 

A Preliminary Report on Treatment of Contact Granuloma With Steroid Injections

1998 ◽  
Vol 7 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Michael A. Crary ◽  
Christine M. Sapienza ◽  
Nicholas J. Cassisi ◽  
G. Paul Moore
Keyword(s):  
Preliminary Report ◽  
Steroid Injection ◽  
Post Injection ◽  
Post Intervention ◽  
Steroid Injections ◽  
Voice Treatment ◽  
Long Term Follow Up ◽  
Local Steroid Injection

This preliminary report discusses the effects of intralesion local steroid injection for treatment of contact granulomas. Four men between the ages of 39 and 59 years and one woman age 33 years, who were diagnosed with contact granulomas and who failed previous management attempts, are discussed. Intralesion steroid injections of triamcinolone were completed in an otolaryngology outpatient clinic. Results showed that the size of contact granulomas was reduced with injection of the steroid in all five patients. Contact granuloma was completely eliminated in one patient. Furthermore, all patients were clinically asymptomatic 3 to 4 months post-injection, although only two of the five granulomas were totally eliminated at the time of long-term follow-up. Clinical improvement was confirmed by direct laryngoscopic evaluation of contact granuloma size 4 months following completion of the steroid injections. A speech-language pathologist's knowledge of this technique may prevent patients with granuloma from enduring protracted voice treatment that is historically less effective. The speech-language pathologist's responsibilities include determining patient candidacy for intralesion steroid injection, assisting the otolaryngologist with endoscopic interpretation of the lesion pre- and post-intervention, and tracking the clinical outcome of the procedure.

Imatinib in Very Elderly (> 75 years) CML Patients: Are Low-Doses (<400 mg daily) Enough?

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2770-2770 ◽  
Author(s):  
Roberto Latagliata ◽  
Massimo Breccia ◽  
Dario Ferrero ◽  
Francesco Cavazzini ◽  
Malgorzata Monika Trawinska ◽  
...  
Keyword(s):  
Overall Survival ◽  
Disease Progression ◽  
Median Time ◽  
Standard Dose ◽  
Chronic Phase ◽  
Published Data ◽  
Very Elderly ◽  
Group 2 ◽  
Lost To Follow Up

Abstract Abstract 2770 In the “real world” of clinical practice, often physicians choose to treat very elderly CML patients with imatinib (IM) at lower than standard (400 mg/day) dose, but there are no published data on the results. To highlight this issue, we retrospectively revised 200 > 75 years old CML patients in chronic phase treated with IM 29 haematological Italian Institutions. We compared 58 patients (29%) who received low-dose IM (≤ 300 mg/day) according to physician decision (LD group) with the remaining 142 patients (71%) who received standard dose IM (SD group). In the SD group, there were 73 males and 69 females with a median age at IM start of 77.9 years (IR 76.0–80.3), Sokal Risk at diagnosis was low in 3 patients, intermediate in 86, high in 39 and not evaluable in 12. Two or more concomitant diseases requiring specific treatments were present in 93/142 patients (65.4%), with 85 patients (59.8%) taking 3 or more concomitant drugs. Twenty-seven patients (19.0%) were in late chronic phase (≥ 12 months from diagnosis before starting IM); on the whole, median time from diagnosis to IM was 1.1 months (IR 0.5–3.0). In the LD group, there were 31 males and 27 females with a median age of 80.2 years (IR 77.9–84.5) at IM start, Sokal Risk at diagnosis was intermediate in 34 patients, high in 17 and not evaluable in 7. Two or more concomitant diseases requiring specific treatments were present in 43/58 patients (74.1%), with 43 patients (74.1%) taking 3 or more concomitant drugs. Fifteen patients (25.8%) were in late chronic phase; on the whole, median time from diagnosis to IM was 1.8 months (IR 0.7–10.4). Starting dose of IM was 300 mg/day in 44 patients (75.8%) and < 300 mg/day in 14 patients (24.2%). According to CTC-AE, grade 3–4 hematological and extra-hematological toxicities were observed in 29 (20.4%) and 30 (21.1%) patients in the SD group compared with 10 (17.2%) and 14 (24.1%) patients in the LD group, respectively. Overall, 63 patients in the SD group (44.3%) required a dose reduction compared to 13 (22.4%) in the LD group (p=0.004): eleven (7.7%) patients in the SD group discontinued IM for toxicity compared to 13 (22.4%) in the LD group (p=0.004). Response to IM in the 2 groups is detailed in the table.SD groupLD grouppN° patients evaluable for response13656Early discontinuation8 (5.8%)8 (14.3%)0.054Resistant disease3 (2.2%)1 (1.8%)0.859Complete haematological response only24 (17.6%)12 (21.4%)0.527Partial cytogenetic response9 (6.6%)6 (10.7%)0.329Complete cytogenetic response92 (67.6%)29 (51.8%)0.052Major molecular response69 (50.7%)17 (30.3%)0.012 After a median follow-up of 33.7 months (IR 18.1–64.7), in the SD group 35 patients died (5 from disease progression and 30 from unrelated causes), 5 patients were lost to follow-up and 102 are still alive: in the LD group, 15 patients died (3 from disease progression and 12 from unrelated causes), 3 patients were lost to follow-up and 40 are still alive. In the SD group, 2-year and 5-year overall survival were 93.2% (CI95% 88.6–97.2) and 65.7% (CI95% 55.0–76.3), respectively; in the LD group, 2-year and 5-year overall survival were 89.7% (CI95% 80.4–98.9) and 67.0% (CI95% 49.6–84.4), respectively. In conclusion, in very elderly CML patients even reduced IM dose appears to be safe and effective enough to achieve sustained cytogenetic and molecular responses with prolonged overall survival. Therefore, also very elderly patients with co-morbidities should have this chance of cure without no upper age limit. Disclosures: Russo Rossi: Novartis: Honoraria; Bristol Myers Squibb: Honoraria. Rosti:Novartis: Consultancy; Bristol Myers Squibb: Consultancy; Novartis: Research Funding; Novartis: Honoraria; Bristol Myers Squibb: Honoraria.

The Effect of Miniscalpel-Needle Versus Steroid Injection for Trigger Thumb Release

2009 ◽  
Vol 34 (4) ◽  
pp. 522-525 ◽  
Author(s):  
M. CHAO ◽  
S. WU ◽  
T. YAN
Keyword(s):  
Steroid Injection ◽  
Trigger Thumb ◽  
Visual Analogue Pain ◽  
Pain Scales ◽  
Percutaneous Release ◽  
Group A ◽  
Release Group ◽  
Group B ◽  
Lost To Follow Up

This study compared the result of percutaneous release using a miniscalpel-needle and steroid injection in 93 trigger thumbs in 83 patients. The patients were randomly assigned to either miniscalpel-needle percutaneous release (group A) or steroid injection (group B). Visual analogue pain scales and patients’ satisfaction were evaluated at baseline, 1 and 12 months. One patient in group A and two patients in group B were lost to follow-up. Forty-four of the 46 trigger thumbs in group A and 12 of 47 trigger thumbs in group B had satisfactory results at 12 months. No digital nerve injury occurred in either group. Percutaneous release with a miniscalpel-needle had a higher success rate than steroid injection.

scholarly journals Caudal Epidural Steroid Injection under Fluoroscopy in Management of Chronic Low Back Pain with or without Radiculopathy

2020 ◽  
Vol 9 (1) ◽  
pp. 3-7
Author(s):  
Rupak Bhattarai ◽  
Bandana Paudel ◽  
Sangeeta Subba ◽  
Kumud Pyakurel ◽  
Bijay K. C. ◽  
...  
Keyword(s):  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Pain Clinic ◽  
Low Back ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Vas Score ◽  
Epidural Steroid ◽  
Caudal Epidural

Background: Low back pain with or without radiculopathy is most common presentations of chronic pain. Caudal epidural steroid injection is one of the treatment modalities of this type of pain syndromes. Materials and Methods: The study was conducted in 100 patient who presented in our pain clinic. These patients were given caudal epidural steroid injections under fluoroscopy guidance with 60 mg depo-methylprednisolone added to 0.5% lignocaine making a volume of 10 ml. All these patients were asked to follow up at pain clinic at 1 month, 3 months & 6 months to assess the visual analogue scale (VAS) score, Oswestry disability index (ODI), Straight leg Raise test (SLRT) & Patient satisfaction scale. Results: There was significant reduction in VAS score in one month, three months and six months follow up after caudal epidural steroid injection. The 50% reduction in pain was seen in 72 patients, 69 patients and 62 patients in one month, three months and six months respectively. The mean VAS score were 7.84 before pre-injection, 4.32 at one hour, 4.06 at one month, 4.18 at 3 months and 4.64 at 6 months after the procedure.The mean ODI were 35.16 before pre-injection, 32.12 at one hour, 28.14 at one month, 28.57 at 3 months and 28.68 at 6 months after the procedure. Conclusion: Caudal epidural steroid injections causes significant relief in pain symptoms of backache with or without radiculopathy and increases the quality of life.  

scholarly journals A better functional outcome with platelet rich plasma compared with local steroid injection in tennis elbow

2021 ◽  
Vol 7 (1) ◽  
pp. 24-28
Author(s):  
Shilp Verma ◽  
Anwar A ◽  
Alok Chandra Agarwal ◽  
Ranjeet Choudhary ◽  
Ankit Kumar Garg
Keyword(s):  
Steroid Injection ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Symptomatic Relief ◽  
Lateral Epicondylitis ◽  
Treatment Modalities ◽  
Functional Activities ◽  
Local Steroid Injection

Lateral epicondylitis commonly referred to as 'tennis elbow,' is mainly observed in the 3rd and 4th decade of life in around 2% -3% of the population. Treatment modalities for lateral epicondylitis include analgesics, immobilization, tennis elbow brace, local steroid infiltration, and ultrasound therapy. Recent studies have explored the effectiveness of platelet-rich plasma (PRP) injections in lateral epicondylitis. We used the block randomization technique. Two groups were prepared with 30 patients in each group. One group of patients received PRP and the other received local steroid injection. Patients were evaluated at the time of procedure and immediately after the procedure, at six weeks, three months, and six months, using the visual analog score and Liverpool's elbow score. At the end of 6 months, follow-up patients in the PRP injection group show good clinical and functional compare to the steroid group of patients. PRP and local corticosteroid injection provide symptomatic relief in the treatment of lateral epicondylitis. PRP infiltration gives better results in pain relief and functional activities with statically significant values when compared with corticosteroid injections.

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