In vivo clinical and radiological effects of platelet-rich plasma on interstitial supraspinatus lesion: Case series

• Published in: Orthopaedics & traumatology, surgery & research surgery & research, 2016-12, Vol.102 (8), p.977-982
• Main Authors: Lädermann, A, Zumstein, M.A, Kolo, F.C, Grosclaude, M, Koglin, L, Schwitzguebel, A.J.P
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Female; Growth factor; Humans; Injections, Intralesional; Leukocyte rich-platelet-rich plasma (L-PRP); Male; Middle Aged; Orthopedics; Pain Measurement; Platelet-Rich Plasma; Platelets; Prospective Studies; Radiography; Rotator Cuff Injuries - diagnostic imaging; Rotator Cuff Injuries - therapy; Rotator cuff lesion; Supraspinatus; Surgery; Treatment Outcome; Wound Healing; Young Adult
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2016.09.010

Abstract Background Rotator cuff tear (RCT) is a frequent condition of clinical relevance that can be managed with a symptomatic conservative treatment, but surgery is often needed. Biological components like leukocytes and platelet rich plasma (L-PRP) could represent an alternative curative method for interstitial RCT. Hypotheses It has been hypothesized that an ultrasound guided L-PRP injection in supraspinatus interstitial RCT could induce radiological healing. Material and methods A prospective case series including 25 patients was performed in order to assess the effect of L-PRP infiltration into supraspinatus interstitial RCTs. Primary outcome was tear size change determined by magnetic resonance imaging arthrogram (MRA) before and 6 months after L-PRP infiltration. Secondary outcomes were Constant score, SANE score, and pain visual analog scale (VAS) after L-PRP infiltration. Results Tear volume diminution was statistically significant ( P = .007), and a >50% tear volume diminution was observed in 15 patients. A statistically significant improvement of Constant score ( P < .001), SANE score ( P = .001), and VAS ( P < .001) was observed. In 21 patients, Constant score improvement reached the minimal clinical important difference of 10.4 points. Discussion We observed a statistically significant and clinically relevant effect on RCT size and clinical parameters after L-PRP infiltration. Such an important improvement of supraspinatus interstitial RCT with conservative management is uncommon, therefore intratendinous L-PRP infiltrations could have been beneficial. This encouraging result could pave the way for future randomized studies in order to formally determinate whether L-PRP infiltrations are a possible alternative to surgical treatment of interstitial RCT. Level of evidence Prospective observational study; Level of evidence II.