Collagen and PRP in Partial Thickness Rotator Cuff Injuries. Friends or Only Indifferent Neighbours? Randomized Controlled Trial

2021 ◽  
Author(s):  
Piotr Godek ◽  
Beata Szczepanowska-Wolowiec ◽  
Dominik Golicki
Keyword(s):  
Rotator Cuff ◽  
Rating Scale ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Combined Therapy ◽  
Initial Assessment ◽  
Partial Thickness ◽  
Rotator Cuff Injuries ◽  
Number Of Patients ◽  
Group A

Abstract INTRODUCTION: Partial thickness rotator cuff injuries (PTRCI) is the sum of degenerative, overload and microtrauma processes, external supply of collagen and platelet-rich plasma (PRP) could potentially counteract deterioration of degenerative tendinopathy.AIM: Comparison of the effectiveness: collagen with PRP, PRP alone, collagen alone in the treatment of PTRCI.METHODS: Ninety patients with PTRCI treated with US–guided injections into the shoulder bursa every consecutive week: Group A - collagen with PRP (n=30), B - collagen alone (n=30), C - PRP alone (n=30). Primary outcomes: numeric rating scale (NRS), QuickDash and EQ-5D-5L questionnaires in control points: IA (initial assessment), T1, T2, T3 – after 6, 12 and 24 weeks, respectively. Secondary outcomes: number of patients with loss of RC continuity, number of regenerated RC between IA and T3.RESULTS: No statistical difference between groups in primary outcomes, tendency for further improvement in A and C group (opposite to group B) between T2 and T3. The RC discontinuity (n = 3, one case in each group) and RC regeneration (n = 65; 73%, 67% and 77%, in group A, B and C, respectively).CONCLUSIONS: Combined therapy of collagen and PRP in PTRCI is not more effective than monotherapies with collagen or PRP. (clinicaltrials.gov - NCT04492748)

scholarly journals The effect of physiotherapy in rotator cuff injury patients with platelet-rich plasma: study protocol of a non-randomized controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chi Zhang ◽  
Jianxiong Wang ◽  
Li Wang ◽  
Yujie Xie ◽  
Fuhua Sun ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Short Form ◽  
Controlled Trial ◽  
Control Group ◽  
Rotator Cuff Injuries ◽  
Rotator Cuff Injury ◽  
Tear Size

Abstract Background The study aims to identify whether Platelet-rich plasma (PRP) combined with early physiotherapy has an advantage over PRP alone for rotator cuff injury patients, regarding pain release, function score, tear size, and quality of life improvement. Methods This is a single-center prospective non-randomized study implemented in July 2019 at the Affiliated Hospital of Southwest Medical University in Sichuan. Three hundred-forteen patients with rotator cuff injury aged over 18 years were recruited. Participants were assigned to the experiment group (PRP plus physiotherapy) or control group (PRP) by their desire. We used the Constant-Murley score to assess the shoulder function, the Visual Analogue Scale to evaluate shoulder pain, and the MOS Item Short-form Health Survey (SF-12) to measure the quality of life. MRI was applied to measure tear size, and the follow-up duration is 12 months. Discussion Our findings will give information on the effects of PRP and physiotherapy on rotator cuff injuries. Physiotherapy might be added to improve the effects of PRP in patients with rotator cuff injuries. Trial registration This study was registered in the Chinese clinical trial registry on September 1st, 2019 (ChiCTR1900025563).

Efficacy of Adjuvant Application of Platelet-Rich Plasma After Needle Aspiration of Calcific Deposits for the Treatment of Rotator Cuff Calcific Tendinitis: A Double-Blinded, Randomized Controlled Trial With 2-Year Follow-up

2021 ◽  
Vol 49 (4) ◽  
pp. 873-882
Author(s):  
Bart W. Oudelaar ◽  
Rianne Huis In ‘t Veld ◽  
Edwin M. Ooms ◽  
Relinde Schepers-Bok ◽  
Rob G.H.H. Nelissen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Mixed Model ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Needle Aspiration ◽  
Randomized Controlled ◽  
Clinical Scores ◽  
Calcific Deposits

Background: Needle aspiration of calcific deposits (NACD) is a frequently used treatment for rotator cuff calcific tendinitis (RCCT). However, a substantial number of patients experience recurrent or persisting shoulder symptoms after NACD. Purpose: To compare the effects of adjuvant application of platelet-rich plasma (PRP) after NACD (NACP+PRP) with those of conventional NACD with corticosteroids (NACD+corticosteroids) on pain, shoulder function, and quality of life (QoL). Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In a single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic RCCT were randomly allocated to receive NACD+corticosteroids or NACD+PRP. Pain, shoulder function, and QoL were assessed at baseline; 6 weeks; and 3, 6, 12, and 24 months after treatment using a numeric rating scale for pain (NRS); the Constant-Murley score (CMS); the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH); the Oxford Shoulder Score (OSS); and the EuroQol 5-dimension scale (EQ-5D). Additionally, resorption of calcific deposits and the integrity of rotator cuff tendons were assessed by using standard radiographs and ultrasound examination, respectively. The results were analyzed using noninferiority analysis for NRS scores and a mixed model for repeated measures. Results: Eighty patients were included (48 female; mean age, 49 ± 6 years; 41 patients in the NACD+PRP group). Both groups showed improvement of clinical scores at the 2-year follow-up ( P < .001 for all clinical scores). NACD+PRP was found to be noninferior to NACD+corticosteroids with regard to the mean decrease of NRS scores (4.34 vs 3.56; P = .003). Mixed-model analysis showed a significant difference in favor of NACD+PRP (CMS, P < .001; DASH, P = .002; OSS, P = .010; EQ-5D, P < .001). However, clinically relevant differences in favor of NACD+PRP were only seen at the 6-month follow-up for NRS and CMS scores, whereas at the 6-week follow-up a clinically relevant difference in favor of NACD+corticosteroids was found for all clinical scores except for the NRS. Full resorption of calcific deposits was present in 84% of the NACD+PRP group compared with 66% in the NACD+corticosteroids group ( P = .081). In the NACD+PRP group, 10 (24%) patients required a second NACD procedure compared with 19 (49%) patients in the NACD+corticosteroids group ( P = .036). Six complications, of which 5 were frozen shoulders, occurred in the NACD+PRP group compared with 1 complication in the NACD+corticosteroids group ( P = .11). Conclusion: NACD+PRP resulted in worse clinical scores at the 6-week follow-up but better clinical scores at the 6-month follow-up compared with NACD+corticosteroids. At the 1- and 2-year follow-ups, the results were comparable between groups. Furthermore, PRP seemed to reduce the need for additional treatments but was associated with more complications. In conclusion, NACD+corticosteroids had a favorable early effect on pain and function combined with low comorbidity. Thus, it remains the treatment of choice for patients with RCCT. Registration: NCT02173743 (ClinicalTrials.gov identifier).

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Folia Medica ◽  
2012 ◽  
Vol 54 (2) ◽  
pp. 27-31 ◽  
Author(s):  
Maria N. Negreva ◽  
Atanas P. Penev
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Combined Therapy ◽  
Beta Blockade ◽  
Recent Onset ◽  
Number Of Patients ◽  
Group A ◽  
Clinically Significant ◽  
Group B ◽  
Onset Atrial Fibrillation

ABSTRACT The incidence of atrial fibrillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fibrillation. OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fibrillation (< 48 hours) for regularization of the rhythm using propafenone. PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fibrillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour. RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05). CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fibrillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically significant.

scholarly journals Stem Cell Surgery and Growth Factors in Retinitis Pigmentosa Patients: Pilot Study after Literature Review

Biomedicines ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 94 ◽  
Author(s):  
Paolo Giuseppe Limoli ◽  
Enzo Maria Vingolo ◽  
Celeste Limoli ◽  
Marcella Nebbioso
Keyword(s):  
Retinitis Pigmentosa ◽  
Platelet Rich Plasma ◽  
Functional Results ◽  
Point Of View ◽  
Foveal Thickness ◽  
Restoration Technique ◽  
Number Of Patients ◽  
Group A ◽  
Cell Surgery ◽  
Group B

To evaluate whether grafting of autologous mesenchymal cells, adipose-derived stem cells, and platelet-rich plasma into the supracoroideal space by surgical treatment with the Limoli retinal restoration technique (LRRT) can exert a beneficial effect in retinitis pigmentosa (RP) patients. Twenty-one eyes underwent surgery and were divided based on retinal foveal thickness (FT) ≤ 190 or > 190 µm into group A-FT and group B-FT, respectively. The specific LRRT triad was grafted in a deep scleral pocket above the choroid of each eye. At 6-month follow-up, group B showed a non-significant improvement in residual close-up visus and sensitivity at microperimetry compared to group A. After an in-depth review of molecular biology studies concerning degenerative phenomena underlying the etiopathogenesis of retinitis pigmentosa (RP), it was concluded that further research is needed on tapeto-retinal degenerations, both from a clinical and molecular point of view, to obtain better functional results. In particular, it is necessary to increase the number of patients, extend observation timeframes, and treat subjects in the presence of still trophic retinal tissue to allow adequate biochemical and functional catering.

Traditional Acupuncture for Reflex Sympathetic Dystrophy: A Randomised, Sham-Controlled, Double-Blind Trial

1995 ◽  
Vol 13 (2) ◽  
pp. 78-80 ◽  
Author(s):  
E Ernst ◽  
KL Resch ◽  
V Fialka ◽  
D Ritter-Dittrich ◽  
Y Alcamioglu ◽  
...  
Keyword(s):  
Reflex Sympathetic Dystrophy ◽  
Rating Scale ◽  
Controlled Trial ◽  
Sham Acupuncture ◽  
Acupuncture Group ◽  
Outcome Variable ◽  
Controlled Study ◽  
Double Blind ◽  
Subjective Success ◽  
Group A

Acupuncture has been suggested as helpful in reflex sympathetic dystrophy (RSD), but no controlled study has yet been published. The hypothesis of this randomised, double-blind, sham-controlled trial, therefore, was that traditional Chinese acupuncture improves subjective as well as objective signs in this condition. Patients were included when suffering from clinically and scintigraphically confirmed acute RSD of the upper or lower limb, with a history between one and four months. They were randomly assigned to either traditional acupuncture (group A) or sham acupuncture (group S). Treatments were applied five times a week for three weeks, each session lasting for 30 minutes. Both groups received identical standard treatments in addition. The primary outcome variable had been pre-defined to be pain, as measured by visual analogue scale assessed before each treatment. Subjective success was also recorded by the patients on a rating scale. Due to force of circumstances, only 14 patients were entered into the study, therefore no test statistics could be performed and the data was evaluated descriptively. At baseline, pain was almost identical in both groups. During the course of the study, patients in group A demonstrated a more pronounced reduction of pain: 28.6% ± 1.9 vs 17.9% ± 2.4 (Mean ± SEM). Similarly, subjective success was rated to favour traditional acupuncture. It is concluded that acupuncture may be useful in the management of pain in patients with acute RSD, but that the present results are not conclusive. Larger, rigorous studies are required to answer the question.

Evaluation of platelet-rich plasma and fibrin matrix to assist in healing and repair of rotator cuff injuries: a systematic review and meta-analysis

2016 ◽  
Vol 31 (2) ◽  
pp. 158-172 ◽  
Author(s):  
Chun-Jiang Fu ◽  
Jia-Bing Sun ◽  
Zheng-Gang Bi ◽  
Xu-Ming Wang ◽  
Cheng-Lin Yang
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Post Treatment ◽  
Score Change ◽  
Platelet Rich Fibrin ◽  
Fibrin Matrix ◽  
Rotator Cuff Injuries ◽  
Functional Scores ◽  
Standard Difference

Objective: To perform a meta-analysis examining the effectiveness of platelet-rich plasma and platelet-rich fibrin matrix for improving healing of rotator cuff injuries. Data sources/design: A meta-analysis of eligible studies was performed after searching Medline, Cochrane, and EMBASE on 14 December 2015. Setting: University hospital. Participants: Patients with rotator cuff injuries. Review methods/intervention: Databases were searched using the keywords “PRP or platelet-rich plasma,” “PRFM or platelet-rich fibrin matrix,” “rotator cuff,” and “platelet-rich” for studies comparing outcomes of patients with rotator cuff injuries that did and did not receive a platelet-rich product. Main measures: The primary outcome was a functional score change from pre- to post-treatment (Scorepost–Scorepre). The secondary outcome was a visual analogue scale (VAS) pain score change from pre- to post-treatment (VASpost–VASpre). Results: A total of 11 studies were included in the meta-analysis. The total number of patients that received platelet-rich plasma or platelet-rich fibrin matrix was 320 and the number of control patients was 318. The standard difference in means of the functional scores was similar between patients administered platelet-rich plasma/fibrin matrix and patients in the control group (standard difference in means for functional scores = 0.029; 95% confidence interval (CI): –0.132 to 0.190; p = 0.725). The standard difference in means was similar between patients administered platelet-rich plasma and the controls (standard difference in means = 0.142; 95% CI: –0.080 to 0.364; p = 0.209). Conclusion: The results of this meta-analysis do not support the use of platelet-rich plasma/platelet-rich fibrin matrix in patients with rotator cuff injuries.

scholarly journals The Effect of Scheduled Intravenous Acetaminophen in an Enhanced Recovery Protocol Pathway in Patients Undergoing Major Abdominal Procedures: A Prospective, Randomized, and Placebo-Controlled Clinical Trial

Pain Medicine ◽  
2021 ◽  
Author(s):  
Kathirvel Subramaniam ◽  
Stephen A Esper ◽  
Kushanth Mallikarjun ◽  
Alec Dickson ◽  
Kristin Ruppert ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Relief ◽  
Abdominal Surgery ◽  
Rating Scale ◽  
Enhanced Recovery ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
Number Of Patients ◽  
Group A

Abstract Objective Enhanced recovery protocols (ERPs) utilize multi-modal analgesia regimens. Individual regimen components should be evaluated for their analgesic efficacy. We evaluated the effect of scheduled intravenous (IV) acetaminophen within an ERP on analgesia and recovery after a major abdominal surgery. Design This study is a prospective, randomized, double-blinded clinical trial. Setting The study setting was a tertiary care, academic medical center. Subjects Adult patients scheduled for elective major abdominal surgical procedures Methods Patients in group A received 1g IV acetaminophen, while patients in group P received IV placebo every six hours for 48 hours postoperatively within an ERP. Pain scores, opioid requirements, nausea and vomiting, time to oral intake and mobilization, length of stay, and patient satisfaction scores were measured and compared. Results From 412 patients screened, 154 patients completed the study (Group A: 76, Group P: 78). Primary outcome was the number of patients with unsatisfactory pain relief, defined as a composite of average Numeric Rating Scale (NRS) scores above 5 and requirement of IV patient-controlled analgesia for pain relief during the first 48 hours postoperatively, and was not significantly different between the two groups (33 (43.4%) in group A versus 42 (53.8%) patients in group P, p=0.20). Opioid consumption was comparable between two groups. Group A utilized significantly less postoperative rescue antiemetics compared to group P (41% vs. 58%, p= 0.02). Conclusions Scheduled administration of IV acetaminophen did not improve postoperative analgesia or characteristics of postoperative recovery in patients undergoing major abdominal surgery within an ERP pathway.

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