Abstract:
Platelet-rich plasma (PRP) is being projected as a newer and superior treatment option for rotator cuff tendinopathy. With the first use of PRP in trauma and orthopedics dating back only to 1998, its advent into the field is relatively recent. Thus, data on long-term efficacy, large cohort studies, or large randomized controlled trials are fairly limited. Moreover, owing to the absence of standardized methods of platelet extraction and lack of consensus on the ideal concentration of platelets in PRP, data comparison from different studies is difficult. Things are complicated by the fact that it is also not clear whether a single injection of PRP is therapeutic or if multiple serial injections are needed to produce the desired effects. The literature on efficacy and pain relief is also obtained from studies with low sample sizes and short follow-ups. The dropout rate and noncompliance rate were also found to be high in some studies. Thus, the data is often not clinically significant and may also be biased due to the non-standardized inclusion and exclusion criteria of the studies. Though multiple studies have suggested good pain control with PRP injection, many studies have found that PRP injection therapy may not be any better than the physical therapy regimen prescribed to patients with rotator cuff tendinopathy. Also, the data on the efficacy of PRP on shoulder function and shoulder range of motion is at variance. This submission aims to evaluate the efficacy and use of PRP in the management of rotator cuff tendinopathy.
摘要:
富血小板血浆(PRP)被认为是肩袖肌腱病的一种新的和优越的治疗选择。随着PRP在创伤和骨科中的首次使用可追溯到1998年,其进入该领域的时间相对较短。因此,长期疗效数据,大型队列研究,或大型随机对照试验相当有限。此外,由于缺乏标准化的血小板提取方法,并且对PRP中理想的血小板浓度缺乏共识,不同研究的数据比较是困难的。由于也不清楚PRP的单次注射是否是治疗性的或者是否需要多次连续注射来产生期望的效果,这一事实使事情变得复杂。关于疗效和疼痛缓解的文献也是从低样本量和短随访的研究中获得的。在一些研究中,辍学率和不依从率也很高。因此,这些数据通常没有临床意义,并且由于研究的非标准化纳入和排除标准,也可能存在偏倚.尽管多项研究表明PRP注射可以很好地控制疼痛,许多研究发现,对于肩袖肌腱病患者,PRP注射治疗可能并不比物理治疗方案更好.此外,PRP对肩关节功能和肩关节活动范围的疗效数据存在差异.本文旨在评估PRP在肩袖肌腱病治疗中的疗效和使用。