scholarly journals Platelet Rich Plasma in Arthroscopic Rotator Cuff Repair: Clinical and Radiological Results of A Prospective RCT Study at 10-Year Follow-Up

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0024
Author(s):  
Pietro Randelli ◽  
Carlo Alberto Stoppani ◽  
Elisabetta Nocerino ◽  
Alessandra Menon ◽  
Riccardo Compagnoni
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Platelet Rich Plasma ◽  
Arthroscopic Rotator Cuff Repair ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Objectives: Despite the technical advancement in arthroscopic rotator cuff repair, inadequate healing or retear of the repaired rotator cuff frequently occurs. The use of biological factors in the surgical treatment has been proved to be effective to enhance tendon healing in the post-operative period. The aim of the study is to compare clinical and radiological outcomes of arthroscopic rotator cuff repair with or without the addition of platelet-rich plasma (PRP) at 10-year follow-up. Methods: Of 53 patients recruited in the study, and randomly divided into two groups (PRP=26; control=27), 38 were re-evaluated at least 10 years after the index procedure. The clinical evaluation was carried out through: University of California at Los Angeles (UCLA) Shoulder Score, Visual Analogue Scale (VAS), Simple Shoulder Test (SST), Constant-Murley Score (CMS), Single Assessment Numerical Evaluation (SANE), American Shoulder and Elbow Surgeons (ASES) and isometric strength in abduction and external rotation. Musculoskeletal ultrasound had been used to evaluate the integrity of the repaired cuff. Results: A number of 38 (71%) patients (PRP=17; control=21) with a median age of 71 [64.75-76.50] years have been evaluated. Satisfaction at follow-up is high (90%), without statistically significant difference between the two groups. We report good and excellent clinical results in both groups (PRP vs control): CMS (81.62 [72.47-85.75] vs 77.97 [69.52-82.55] points), UCLA (34 [29.00-35.00] vs 33 [29.00-35.00] points), VAS (0.34 [0.00-1.85] vs 0.70 [0.00-2.45] cm), ASES (100.00 [94.17-100.00] vs 93.33 [68.33-100.00] points), SANE (100 [80-100] vs 80 [70-90] points), SST (12.00 [11.00-12.00] vs 12.00 [9.00-12.00] points),shoulder abduction strength (3.92 ± 2.30 vs 3.20 [1.72-4.65] kg), shoulder external rotation strength (5.31 ± 2.77 vs 4.36 ± 2.05 kg). It was not possible to find a statistically significant difference for the variables analysed, except for few subjective variables (ASES, SANE). On average, 37% of the operated patients had a re-rupture at the ultrasound examination, with no significant difference between the two groups (p=1.00). Compared with the previous radiological control at the 2-year follow-up, new retears occurred in 6% of the patients that received PRP treatment, whereas in the control group the percentage raises to 14% (p=0.61). Conclusions: The clinical and radiological outcomes at the 10-year follow-up show a substantial uniformity of results between the two groups. The clinical differences that had been observed at 2-year follow-up disappeared at long term. A reduction in retear rate is observed at US evaluation in the PRP group at 10 years follow-up and this trend needs to be further analyzed. Patients’ satisfaction is still high 10 years after surgical treatment, in both groups.

Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up

2011 ◽  
Vol 20 (4) ◽  
pp. 518-528 ◽  
Author(s):  
Pietro Randelli ◽  
Paolo Arrigoni ◽  
Vincenza Ragone ◽  
Alberto Aliprandi ◽  
Paolo Cabitza
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Biceps Tenodesis Combined With Rotator Cuff Repair Increases Functional Status And Elbow Strength In Both Operated And Contralateral Arms

2020 ◽  
Author(s):  
Ali Ihsan KILIC ◽  
Onur HAPA ◽  
Ramadan OZMANEVRA ◽  
Nihat Demirhan DEMIRKIRAN ◽  
Onur GURSAN
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Elbow Flexion ◽  
Arthroscopic Rotator Cuff Repair ◽  
Biceps Tenodesis ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Purpose: Aim of the present study was to prospectively evaluate the elbow flexion and supination strengths, and the functional outcomes of patients after arthroscopic rotator cuff repair combined with simultaneous biceps tenodesis.Methods: Nineteen patients who underwent arthroscopic rotator cuff repair and biceps tenodesis with at least 24 months follow-up were included. Patients were evaluated using a visual analogue scale (VAS) for bicipital groove pain, American Shoulder and Elbow Surgeons (ASES), and constant scores(CS), biceps apex distance (BAD), elbow flexion and supination strengths.Results: VAS for biceps groove measurement averages of postoperative 6th, 12th and 24th month were lower in comparison to pre-operative data and were considered to be statistically significant (p<0.05). Constant score, an average of all post-operative measurements and scores were found higher than pre-operative values and was considered to be statistically significant (p<0,01). There was a significant difference in the comparison of operated and contralateral forearm supination and elbow flexion muscle strength measurements at postoperative 3rd and 6th-month follow-up (p<0.01).Conclusion: Arthroscopic biceps tenodesis into the anchors of lateral row combined rotator cuff repair provides an increase in strength of elbow flexion and forearm supination, while decreases pain. Level of Evidence: Level IV

scholarly journals Bilateral single-staged arthroscopic rotator cuff repair is comparable to staged procedures: a retrospective follow up study of 2 years

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chen Wang ◽  
Pu Yang ◽  
Dongfang Zhang ◽  
In-Ho Jeon ◽  
Tengbo Yu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Rotator Cuff Repair ◽  
Single Stage ◽  
Arthroscopic Rotator Cuff Repair ◽  
Significant Difference ◽  
Outcome Scores ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Background Bilateral rotator cuff tears are not uncommon and the timing of the surgical treatment of both shoulders is debated. In the present study, we aimed to compare the clinical outcomes of patients who underwent single-stage or staged bilateral arthroscopic rotator cuff repair. Methods From March 2013 to May 2018, a retrospective review on all patients who underwent bilateral arthroscopic rotator cuff repair at our department was performed. Patients were separated into 2 groups: single-stage and staged. The minimum follow-up period was 2 years. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Constant-Murley (Constant) score, the range of motion (ROM) of the shoulder and the hospitalization costs were evaluated for comparison between the two groups before and after the operation. Differences between groups were assessed using t-tests and ANOVA. Results All 51 patients completed follow-up of 2 years, single stage (n = 24) and staged group (n = 27). There was no significant difference in the VAS, ASES, UCLA and Constant scores between the single-stage group and the staged group before the operation. Postoperative clinical scores were significantly improved in both groups (P < 0.05). All outcome scores were significantly different between the two groups at 6 months postoperatively, and the staged scored better than the single-stage (P < 0.05). At 12, 18, and 24 months after the operation, the outcome scores were not significantly different between the two groups. At follow-up, the ROM of the shoulder was not significantly different between the two groups. In the single-stage group, the outcome scores and ROM were similar for both shoulders and comparable to the staged group. We also found significant cost savings in the single-stage group (4440.89 ± 130.55 USD) compared to the staged group (5065.73 ± 254.76 USD) (p < 0.05). Conclusions Patients receiving single-stage or staged bilateral arthroscopic rotator cuff repair showed similarly good clinical outcomes at follow-ups longer than 6 months. Moreover, good outcomes were observed on both sides of the single-stage group.

Is It Safe to Inject Corticosteroids Into the Glenohumeral Joint After Arthroscopic Rotator Cuff Repair?

2019 ◽  
Vol 47 (7) ◽  
pp. 1694-1700 ◽  
Author(s):  
Yang-Soo Kim ◽  
Hong-Ki Jin ◽  
Hyo-Jin Lee ◽  
Hyung-Lae Cho ◽  
Wan-Seok Lee ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Significant Difference ◽  
Group 2 ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Group 1

Background: Injection of intra-articular corticosteroids is effective for improving the recovery of range of motion (ROM) and pain in various conditions of the shoulder but its use is limited after rotator cuff repair owing to concern over the possible harmful effects of steroids on the repaired tendon. Purpose: To evaluate the effect of intra-articular corticosteroid injections on the clinical outcomes and cuff integrity of patients after rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Between March 2011 and April 2014, 80 patients with a small- to medium-sized rotator cuff tear were enrolled in this study and underwent arthroscopic rotator cuff repair. Forty patients received an injection of triamcinolone (40 mg) and lidocaine (1.5 mL) into the glenohumeral joint 8 weeks after surgery (group 1), while the remaining 40 patients received normal saline injection (group 2). Outcome measures—including ROM, American Shoulder and Elbow Surgeons (ASES) score, Constant score, pain visual analog scale, and Simple Shoulder Test score—were evaluated at 3, 6, and 12 months after surgery and at the last follow-up. The integrity of the repaired tendon was evaluated by magnetic resonance imaging (MRI) and classified per Sugaya classification at 8 weeks (before injection) and 12 months after surgery. Results: The mean follow-up period was 25.7 months. At 3 months postoperatively, patients in group 1 had a significantly higher ROM with respect to forward flexion ( P = .05), external rotation at the side ( P = .05), and external rotation at abduction ( P = .04) as compared with group 2, whereas no significant difference was noted between the groups for internal rotation behind the back ( P = .65). Patients in group 1 had significantly lower visual analog scale pain scores ( P = .02) and higher ASES scores (group 1, 68.90; group 2, 60.28; P = .02) at 3-month follow-up. However, there was no significant difference after 6 months with respect to ROM and ASES scores (group 1, 77.80; group 2, 75.88; P = .33). Retears (Sugaya classification IV and V) were determined by MRI at 12 months and observed in a total of 7 patients (8.8%): 3 from group 1 (7.5%) and 4 from group 2 (10%). No retears were observed on MRI in the remaining 73 patients (91.2%): 37 patients from group 1 and 36 patients from group 2. There was no statistically significant difference in rate of retears between groups ( P = .69). Conclusion: Intra-articular injection of corticosteroids after rotator cuff repair does not increase the risk of retears and is thus an effective and safe treatment method for increasing ROM (forward flexion, external rotation) and improving clinical score (ASES) during the early postoperative period of patients undergoing rotator cuff repair.

Does an Injection of Adipose-Derived Mesenchymal Stem Cells Loaded in Fibrin Glue Influence Rotator Cuff Repair Outcomes? A Clinical and Magnetic Resonance Imaging Study

2017 ◽  
Vol 45 (9) ◽  
pp. 2010-2018 ◽  
Author(s):  
Yong Sang Kim ◽  
Chang Hun Sung ◽  
Sung Hoon Chung ◽  
Sang Joon Kwak ◽  
Yong Gon Koh
Keyword(s):  
Rotator Cuff ◽  
Fibrin Glue ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Conventional Group ◽  
Injection Group ◽  
The Mean ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: The mesenchymal stem cell (MSC)–based tissue engineering approach has been developed to improve the treatment of rotator cuff tears. Hypothesis/Purpose: The purpose was to determine the effect of an injection of adipose-derived MSCs loaded in fibrin glue during arthroscopic rotator cuff repair on clinical outcomes and to evaluate its effect on structural integrity using magnetic resonance imaging (MRI). The hypothesis was that the application of adipose-derived MSCs would improve outcomes after the surgical repair of a rotator cuff tear. Study Design: Cohort study; Level of evidence, 3. Methods: Among 182 patients treated with arthroscopic surgery for a rotator cuff tear, 35 patients treated with arthroscopic rotator cuff repair alone (conventional group) were matched with 35 patients who underwent arthroscopic rotator cuff repair with an injection of adipose-derived MSCs loaded in fibrin glue (injection group) based on sex, age, and lesion size. Outcomes were assessed with respect to the visual analog scale (VAS) for pain, range of motion (ROM) (including forward flexion, external rotation at the side, and internal rotation at the back), and functional measures of the Constant score and University of California, Los Angeles (UCLA) shoulder rating scale. Repaired tendon structural integrity was assessed by using MRI at a minimum of 12 months after surgery, and the mean clinical follow-up was 28.8 ± 4.2 months in the conventional group and 28.3 ± 3.8 months in the injection group. Results: The mean VAS score at rest and during motion improved significantly in both groups after surgery. However, there were no significant differences between the groups at the final follow-up ( P = .256 and .776, respectively). Compared with preoperative measurements, forward flexion and external rotation at the side significantly improved at the final follow-up in both groups (all P < .05). However, no significant improvements in internal rotation at the back were observed in either group ( P = .625 and .834 for the conventional and injection groups, respectively). There were also no significant differences between the groups at the final follow-up for any of the 3 ROM positions (all P > .05). The mean Constant score and UCLA score improved significantly in both groups after surgery, but there were no significant differences between the groups at the final follow-up ( P = .634 and .302, respectively). MRI indicated a retear rate of 28.5% in the conventional group and 14.3% in the injection group ( P < .001). Conclusion: This study revealed that an injection of adipose-derived MSCs loaded in fibrin glue during rotator cuff repair could significantly improve structural outcomes in terms of the retear rate. There were, however, no clinical differences in the 28-month period of follow-up. Although still in the early stages of application, MSC augmentation of surgical rotator cuff repair appears useful for providing an adequate biological environment around the repair site.

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