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Lee HW, Choi KH, Kim JY, Yang I, Noh KC. Prospective Clinical Research of the Efficacy of Platelet-rich Plasma in the Outpatient-based Treatment of Rotator Cuff Tendinopathy. Clin Shoulder Elb 2019; 22:61-69. [PMID: 33330197 PMCID: PMC7714302 DOI: 10.5397/cise.2019.22.2.61] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 01/08/2023] Open
Abstract
Background The purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP. Methods Inclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure. Results There was a statistically significant difference in ΔASES3months (ASES3months-ASESfirst) score between the control and PRP groups (p=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (p>0.05). Conclusions This study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.
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Affiliation(s)
- Ho-Won Lee
- Department of Orthopedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Kyung-Ho Choi
- Department of Orthopedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jung-Youn Kim
- Department of Orthopedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Ik Yang
- Department of Orthopedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Kyu-Cheol Noh
- Department of Orthopedic Surgery, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
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Lim W, Park SH, Kim B, Kang SW, Lee JW, Moon YL. Relationship of cytokine levels and clinical effect on platelet-rich plasma-treated lateral epicondylitis. J Orthop Res 2018; 36:913-920. [PMID: 28851099 DOI: 10.1002/jor.23714] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/19/2017] [Indexed: 02/04/2023]
Abstract
Lateral epicondylitis (LE) is difficult to manage and can result in significant patient morbidity. Currently, the clinical use of platelet-rich plasma (PRP) for painful tendons has received attention, but its efficacy remains controversial. This study aimed to investigate the clinical effects of PRP and its biological components. A total of 156 patients with LE were randomly divided into group 1, treated with a single injection of 2-ml autologous PRP, and group 2, treated with a control received only physical therapy without injection. Both groups used a tennis elbow strap and performed stretching and strengthening exercises during 24 weeks' follow-up. Pain and functional improvements were assessed using the visual analog scale (VAS), Modified Mayo Clinic Performance Index for the elbow, and magnetic resonance imaging (MRI). White blood cell count, platelet count, and levels of platelet-derived growth factor-AB (PDGF-AB), PDGF-BB, transforming growth factor-β (TGF-β), vascular endothelial growth factor, epithelial growth factor, and interleukin-1 β in PRP were measured and investigated for statistical correlation with the clinical score. At 24 weeks, all pain and functional variables, including VAS score, Mayo Clinic performance scores, and MRI grade, improved significantly in group 1 (p < 0.05). PDGF-AB, PDGF-BB, and TGF-β levels were more significantly increased in PRP than in whole blood. TGF-β level significantly correlated with Mayo Clinic performance score and MRI grade improvement. Thus, TGF-β level in PRP is considered to play a pivotal role in tendon healing. These results may contribute to identifying the best protocol for PRP application in tendinopathies. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:913-920, 2018.
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Affiliation(s)
- Wonbong Lim
- Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.,Laboratory of Orthopedic Research, Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.,Department of Premedical Program, School of Medicine, Chosun University, Gwangju, 61452, South Korea
| | - Sang H Park
- Run Orthopedic Hospital, Nam-gu, Gwangju, South Korea
| | - Bora Kim
- Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.,Laboratory of Orthopedic Research, Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
| | - Sin W Kang
- Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.,Laboratory of Orthopedic Research, Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
| | - Jung W Lee
- Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.,Laboratory of Orthopedic Research, Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
| | - Young L Moon
- Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.,Laboratory of Orthopedic Research, Department of Orthopedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
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