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

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.

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Assessment of Rotator Cuff Partial Tear Treatment with Ultrasound Guided Platelet Rich Plasma Injection

QJM ◽

10.1093/qjmed/hcab106.046 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hana Hamdy Nassef ◽

Amir Louis Louka ◽

Mohamed Tarek Ali Abdelhamid Khedr

Keyword(s):

Rotator Cuff ◽

Platelet Rich Plasma ◽

Rotator Cuff Tears ◽

Ultrasound Guided ◽

University Hospitals ◽

Partial Tear ◽

Plasma Injection ◽

Partial Tears ◽

Work Assessment ◽

Shoulder Score

Abstract Background Rotator cuff tears are a common orthopedic problem, and often these tears are so-called partial tears of the rotator cuff. A partial tear of the rotator cuff is an area of damage or degeneration to the rotator cuff tendons, where the tear does not go all the way through the tendons Objectives The aim of the work assessment of rotator cuff partial tear treatment with ultrasound guided platelet rich plasma injection. Patients and Methods Single arm interventional study which was conducted in Ain shams university hospitals in the period between March 2020 and October 2020, 10 confirmed cases of rotator cuff partial tear diagnosed by MRI were included in this study. Their ages ranging from 25 to 70 years old. Results Our study showed statistically significant improvements in 10 patients in VAS pain score, constant shoulder score, PENN shoulder score and OXFORD shoulder score. Conclusion The ultrasound-guided PRP injection for rotator cuff partial thickness tears is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising and wellproved results. PRP has the potential to heal the muscle-tendon unit of the rotator cuff and may be a primary nonsurgical treatment modality for rotator cuff tears.

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The effect of platelet-rich plasma injections in the non-surgical treatment of a partial rotator cuff tear

International Journal of Case Reports and Images ◽

10.5348/ijcri-201493-cr-10404 ◽

2014 ◽

Vol 5 (7) ◽

pp. 524 ◽

Cited By ~ 2

Author(s):

Julien Freitag ◽

Ross Lenssen ◽

Drew Slimmon ◽

Simon Balster

Keyword(s):

Surgical Treatment ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Platelet Rich Plasma ◽

Cuff Tear ◽

Partial Rotator Cuff Tear ◽

Non Surgical Treatment

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Clinical outcome of ultrasound-guided atelocollagen injection for patients with partial rotator cuff tear in an outpatient clinic: a preliminary study

Clinics in Shoulder and Elbow ◽

10.5397/cise.2020.00066 ◽

2020 ◽

Vol 23 (2) ◽

pp. 80-85

Author(s):

Sang Hoon Chae ◽

Jae Yeon Won ◽

Jae Chul Yoo

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Outpatient Clinic ◽

Injection Pain ◽

Post Injection ◽

Ultrasound Guided ◽

Analog Scale ◽

Cuff Tear ◽

Significant Difference ◽

Partial Rotator Cuff Tear

Background: Atelocollagen has been studied for restoration of rotator cuff tendon. In this study, we attempted to evaluate the clinical outcome of ultrasound-guided atelocollagen injection in an outpatient clinic for patients with partial rotator cuff tear.Methods: We recruited 42 outpatients who visited our hospital from May 2019 to September 2019. Atelocollagen injection was performed in patients with partial rotator cuff tear diagnosed by magnetic resonance imaging and ultrasound. American Shoulder and Elbow Surgeons (ASES), Constant, Korean Shoulder Score (KSS) and Simple Shoulder Test (SST) scores, and range of motion were assessed before injection and after two months. Statistically, we analyzed the clinical results using the Wilcoxon signed rank test.Results: Finally, 15 patients were enrolled for analysis. There was no significant difference between pre- and post-injection in terms of range of motion, ASES (57.0 vs. 60.4), Constant (56.4 vs.58.9), KSS (64.6 vs.68.5), and pain-visual analog scale (4.2 vs.3.7), except function-visual analog scale (F-VAS; 6.3 vs.7.1) and SST (6.6 vs.6.9). A significant difference was found in SST (P=0.046) and F-VAS (P=0.009). According to the ultrasound results at 2 months, we found hyperechoic materials in three of seven patients. The most common complication of atelocollagen injection was post-injection pain (53%, 8/15).Conclusions: Ultrasound-guided atelocollagen injection for partial rotator cuff tear showed no significant change in terms of clinical outcomes, except for F-vas and SST score. Tendon regeneration was not clear due to the remnants of atelocollagen present at 2-month follow-up ultrasound. There seems to be alarming post-injection pain for 2 to 3 days in the patients who received atelocollagen injection in an outpatient clinic.

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Platelet-rich plasma for the improvement in shoulder function in rotator cuff disorders

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20185339 ◽

2018 ◽

Vol 5 (1) ◽

pp. 156

Author(s):

Shashi Kant Kumar Singh ◽

Ankur Ojha

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Platelet Rich Plasma ◽

Shoulder Function ◽

Rotator Cuff Tears ◽

Time Interval ◽

New Treatment ◽

One Year ◽

Partial Rotator Cuff Tear ◽

Shoulder Score

Background: Among causes of shoulder pain, rotator cuff disorders are very common. The exact pathogenesis of rotator cuff tears is not clearly understood. To improve outcomes, the relatively new technique of injection of PRP is under investigation. Purpose of this study is to clinically evaluate the efficacy of new treatment of PRP injection in shoulder pain due to rotator cuff pathology.Methods: A prospective, observational study, on patients with shoulder pain diagnosed as rotator cuff disorders admitted in Department of Orthopaedics, RIMS, Ranchi during one year time interval (from 10th October 2016 to 09th October 2017) in the age ranging from 41 to 80 years with a mean age of 57.90 years was conducted. 20 Patients were selected for the study. Initial pre-injection score of patient taken on constant shoulder score and noted. Patient underwent intra-articular injection of PRP in shoulder joint through posterior approach under local anaesthesia. Patients were followed up at 1st post-injection day, 1 month, 3 months and 6 months after the injection.Results: Results were analysed according to constant shoulder score. In partial tear 5 (41.67%) have excellent, 6 (50%) have good and 1 (8.33%) has fair outcome on 6 months follow up and in full tear all 8 (100%) patients have poor outcome and none of the patients developed any complication.Conclusions: A single injection of PRP resulted in a safe, significant, sustained improvement in pain and functional outcomes for patients with refractory partial rotator cuff tear (RCT).

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Ultrasound-Guided platelet-Rich plasma (PRP) injection in partial-thickness rotator cuff tear

National Journal of Clinical Orthopaedics ◽

10.33545/orthor.2019.v3.i3a.158 ◽

2019 ◽

Vol 3 (3) ◽

pp. 33-35

Author(s):

Dr. Umang Agrawal ◽

Dr. Rahul Parmar

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Platelet Rich Plasma ◽

Ultrasound Guided ◽

Cuff Tear ◽

Partial Thickness

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Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

American Journal of Sonography ◽

10.25259/ajs-22-2018 ◽

2018 ◽

Vol 1 ◽

pp. 9

Author(s):

Harshad Arvind Vanjare ◽

Jyoti Panwar

Keyword(s):

Rotator Cuff ◽

Negative Predictive Value ◽

Rotator Cuff Tear ◽

Predictive Value ◽

Rotator Cuff Tears ◽

Mri Findings ◽

Cuff Tear ◽

Experienced Operator ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

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DOES HYPERCHOLESTOLEMIA PREDISPOSE TO ROTATOR CUFF PATHOLOGIES?

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i4.16883 ◽

2017 ◽

Vol 10 (4) ◽

pp. 373 ◽

Cited By ~ 1

Author(s):

Surendra Umesh Kamath ◽

Sunil Murthy

Keyword(s):

Rotator Cuff ◽

Total Cholesterol ◽

Rotator Cuff Tear ◽

Indian Population ◽

Statistical Significance ◽

Elevated Serum ◽

Density Lipoprotein ◽

Rotator Cuff Tears ◽

Control Group ◽

Cuff Tear

Background: Rotator cuff tear are one of most common orthopedic musculoskeletal problem gaining importance due to large health scale expenditure. Causes of rotator cuff tears are multifactorial and unclear. Previous studies have suggested relation between elevated serum lipid profile and rotator cuff tear in western population. We therefore undertook study in our Indian population to correlate association of hypercholesterolemia with rotator cuff tear.Objective: To find association of rotator cuff pathology with hypercholesterolemia in Indian patients.Materials and methods: After obtaining clearance from institutional ethics committee. We prospectively collected fasting lipid samples of population who came to our hospitals with complaints of shoulder pain during our study period. 50 patients had rupture of rotator cuff which was confirmed by ultrasound of involved shoulder. 50 were seen for non-cuff related complaints. We followed strict inclusion and exclusion criteria.Results: Total cholesterol, Triglycerides and low density lipoprotein concentration of patients with rotator cuff tendon tear were on higher side than control group. High density lipoprotein trend showed being lower than control group. 21 of 50 (42%) had high cholesterol (total cholesterol greater than 240mg/dl) than compared to 18 of 50 (36%) in control group. however P value=0.539 and showed no statistical significance between groups.Conclusion: In Indian population there was no correlation between hypercholesterolemia and rotator cuff tear which is statistically significant.Key words Rotator cuff tear, Hypercholesterolemia, Indian population.

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Calcific tendinitis of the shoulder in the Korean population: demographics and its relation with coexisting rotator cuff tear

Clinics in Shoulder and Elbow ◽

10.5397/cise.2020.00010 ◽

2021 ◽

Vol 24 (1) ◽

pp. 21-26

Author(s):

Yon-Sik Yoo ◽

Jin-Young Park ◽

Myung-sun Kim ◽

Nam-Su Cho ◽

Yong-Beom Lee ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Mean Value ◽

Calcific Tendinitis ◽

Older Age ◽

Korean Population ◽

Rotator Cuff Tears ◽

Treatment Modalities ◽

Duration Of Symptoms ◽

Cuff Tear

Background: To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear.Methods: Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. Results: There were 402 female patients (79%) with mean age of 55 years (range, 31–87 years). Mean duration of symptoms was 15.5 months. Mean size of calcific materials was 11.4 mm (range, 0.9-35). Mean value of VAS and ASES scores were 6.5 (range, 1–10) and 47 (range, 8–95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all P<0.05).Conclusions: This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.

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The greater tuberosity radius ratio: maybe a new predictor in diagnosis of rotator cuff tear

10.21203/rs.3.rs-41294/v1 ◽

2020 ◽

Author(s):

Qi Ma ◽

Changjiao Sun ◽

Pu Liu ◽

Sha Wu ◽

Xu Cai

Keyword(s):

Computed Tomography ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Roc Curve ◽

Radius Ratio ◽

Rotator Cuff Tears ◽

Cutoff Value ◽

Greater Tuberosity ◽

Cuff Tear ◽

Computed Tomography Images

Abstract Background The role of the greater tuberosity of humerus in subacromial impingement should be of equal important as the acromion. In this study we concerned on the morphological characteristics of the greater tuberosity of humerus and proposed the greater tuberosity radius ratio (GTRR) as a new predictor for the diagnosis of rotator cuff tear. We hypothesized that a larger value of the GTRR could increase the risk of developing rotator cuff tear. Methods This was a retrospective study and clinical data and preoperative computed tomography images of the patients with rotator cuff tears (defined as the RCT group, simple size: 61) or without rotator cuff tears (defined as the control group, simple size: 56) were collected. Three-dimensional models of shoulders were established by multiplanar reconstruction of computed tomography scans. In a standard anteroposterior view, the radius of the best-fit circle of the humeral head (the r) and the radius of the concentric circle passing through the most superolateral edge of the greater tuberosity (the R) were measured for each shoulder. The ratio of R and r (R/r) was defined as the greater tuberosity radius ratio (GTRR). Independent samples t tests were used to find significant differences within the r, the R and the GTRR between groups. Receiver operating characteristic (ROC) curve based on the values of GTRR was performed to determine an applied cutoff value which may be useful in clinical practice. Results There was no significant difference in the values of r or R. However, the mean values of GTRR were 1.339 ± 0.143 (range, 1.087–1.684) and 1.244 ± 0.172 (range, 1.040–1.706) in the two groups respectively (p = 0.002). According to the ROC curve, an optimized cutoff value of GTRR was determined as 1.262, whose sensitivity was 72% and specificity was 65% for diagnosis of rotator cuff tear. Conclusion The greater tuberosity of humerus contributes to the mechanisms of rotator cuff tear. The greater tuberosity radius ratio is recommended as a new predictor for diagnosis of rotator cuff tear, with an optimized cutoff value set as 1.262.

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