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Kuo SJ, Su YH, Hsu SC, Huang PH, Hsia CC, Liao CY, Chen SH, Wu RW, Hsu CC, Lai YC, Liu DY, Ku NE, Chen JF, Ko JY. Effects of Adding Extracorporeal Shockwave Therapy (ESWT) to Platelet-Rich Plasma (PRP) among Patients with Rotator Cuff Partial Tear: A Prospective Randomized Comparative Study. J Pers Med 2024; 14:83. [PMID: 38248784 PMCID: PMC10820784 DOI: 10.3390/jpm14010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
A rotator cuff tear is a prevalent ailment affecting the shoulder joint. The clinical efficacy of combined therapy remains uncertain for partial rotator cuff tears. In this study, we integrated extracorporeal shockwave therapy (ESWT) with platelet-rich plasma (PRP) injection, juxtaposed with PRP in isolation. Both cohorts exhibited significant improvements in visual analogue scale (VAS), Constant-Murley score (CMS), degrees of forward flexion, abduction, internal rotation, and external rotation, and the sum of range of motion (SROM) over the six-month assessment period. The application of ESWT in conjunction with PRP exhibited notable additional enhancements in both forward flexion (p = 0.033) and abduction (p = 0.015) after one month. Furthermore, a substantial augmentation in the range of shoulder motion (SROM) (p < 0.001) was observed after six months. We employed isobaric tag for relative and absolute quantitation (iTRAQ) to analyze the differential plasma protein expression in serum samples procured from the two groups after one month. The concentrations of S100A8 (p = 0.042) and S100A9 (p = 0.034), known to modulate local inflammation, were both lower in the ESWT + PRP cohort. These findings not only underscore the advantages of combined therapy but also illuminate the associated molecular changes.
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Affiliation(s)
- Shu-Jui Kuo
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung 404327, Taiwan
| | - Yu-Hsiang Su
- Department of Education, China Medical University Hospital, Taichung 404327, Taiwan; (Y.-H.S.); (C.-C.H.)
| | - Shih-Chan Hsu
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Po-Hua Huang
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Chia-Chun Hsia
- Department of Education, China Medical University Hospital, Taichung 404327, Taiwan; (Y.-H.S.); (C.-C.H.)
| | - Chin-Yi Liao
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Sung-Hsiung Chen
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Re-Wen Wu
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Chieh-Cheng Hsu
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Yen-Chun Lai
- School of Medicine, National Taiwan University, Taipei 100233, Taiwan;
| | - De-Yi Liu
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Nien-En Ku
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Jui-Feng Chen
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Jih-Yang Ko
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
- Center for Shockwave Medicine and Tissue Engineering, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan
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