PDF(Pubmed)
Abstract：
UNASSIGNED: Prior research has demonstrated that platelet-rich plasma (PRP) has shown promising results in the treatment of knee osteoarthritis, lateral epicondylitis, and rotator cuff disease. However, there is a lack of standardization with PRP regarding its use for partial thickness rotator cuff tears (PTRCTs). The primary objective of this review is to assess the location of PRP injections in the shoulder, and how it corresponds to shoulder functional outcomes in PTRCTs.
UNASSIGNED: Data sources included randomized controlled trials (RCTs) conducted between January 2010 and September 2021 with the terms PRP, partial thickness rotator cuff tears, intra-articular injections, subacromial injections, and intratendinous injections. Major inclusion criteria: partial thickness rotator cuff tears only, functional outcome scores pre-injection and post-injection, minimum 2-month follow-up time, and nonsurgical PRP injections only. Major exclusion criteria: PRP used as an adjunct therapy, full-thickness rotator cuff tears, and surgical intervention before treatment.
UNASSIGNED: A total of 8 RCTs were included which utilized PRP injected into the shoulder for PTRCTs. Studies were grouped by the location of the injection with the following breakdown: 1 glenohumeral joint, 4 subacromial bursa, and 3 intratendinous as the site of injection of PRP. Intra-articular PRP showed a 46.2% improvement (P < .05) in the Disabilities of the Arm, Shoulder, and Hand score at 12-month follow-up, however PRP compared to physical therapy had no statistical difference. For subacromial injections, one study showed no statistical difference between hyaluronic acid and PRP vs PRP, but both groups showed improvement compared to normal saline at 3, 6, and 12 months (P < .05). For intratendinous injections, PRP was found to be superior in the Shoulder Pain and Disability Index scores at 66.1% improvement (P < .05) at 3 months and 71.6% at 6 months (P < .05) after two PRP injections when compared to dry needling. Another study showed a statistically significant difference in ASES score when combining LP-PRP injection intratendinous and subacromial bursa when compared to corticosteroid at 3 months. Furthermore, at 6-month follow-up, the PRP group showed significant improvement in the Oxford Shoulder Score compared to a subacromial bursa corticosteroid group 53.8% vs 31.7% (P < .01).
UNASSIGNED: Based on our review of current literature, there is inconclusive evidence of the ideal location to inject PRP when partial rotator cuff tear is present. Despite PRP showing improved functional outcomes in patients diagnosed with PTRCT regardless of the injection site, more research is needed to figure out the optimal concentration of PRP, frequency of injection, and who are ideal candidates when utilizing PRP for PTRCTs.
UNASSIGNED: Data sources included randomized controlled trials (RCTs) conducted between January 2010 and September 2021 with the terms PRP, partial thickness rotator cuff tears, intra-articular injections, subacromial injections, and intratendinous injections. Major inclusion criteria: partial thickness rotator cuff tears only, functional outcome scores pre-injection and post-injection, minimum 2-month follow-up time, and nonsurgical PRP injections only. Major exclusion criteria: PRP used as an adjunct therapy, full-thickness rotator cuff tears, and surgical intervention before treatment.
UNASSIGNED: A total of 8 RCTs were included which utilized PRP injected into the shoulder for PTRCTs. Studies were grouped by the location of the injection with the following breakdown: 1 glenohumeral joint, 4 subacromial bursa, and 3 intratendinous as the site of injection of PRP. Intra-articular PRP showed a 46.2% improvement (P < .05) in the Disabilities of the Arm, Shoulder, and Hand score at 12-month follow-up, however PRP compared to physical therapy had no statistical difference. For subacromial injections, one study showed no statistical difference between hyaluronic acid and PRP vs PRP, but both groups showed improvement compared to normal saline at 3, 6, and 12 months (P < .05). For intratendinous injections, PRP was found to be superior in the Shoulder Pain and Disability Index scores at 66.1% improvement (P < .05) at 3 months and 71.6% at 6 months (P < .05) after two PRP injections when compared to dry needling. Another study showed a statistically significant difference in ASES score when combining LP-PRP injection intratendinous and subacromial bursa when compared to corticosteroid at 3 months. Furthermore, at 6-month follow-up, the PRP group showed significant improvement in the Oxford Shoulder Score compared to a subacromial bursa corticosteroid group 53.8% vs 31.7% (P < .01).
UNASSIGNED: Based on our review of current literature, there is inconclusive evidence of the ideal location to inject PRP when partial rotator cuff tear is present. Despite PRP showing improved functional outcomes in patients diagnosed with PTRCT regardless of the injection site, more research is needed to figure out the optimal concentration of PRP, frequency of injection, and who are ideal candidates when utilizing PRP for PTRCTs.
摘要：
■先前的研究表明，富血小板血浆（PRP）在治疗膝骨关节炎方面显示出有希望的结果，外上髁炎,和肩袖疾病。然而,关于PRP用于部分厚度肩袖撕裂（PTRCT）的标准缺乏。本综述的主要目的是评估PRP注射在肩部的位置，以及它如何对应于PTRCT中的肩关节功能结果。
■数据来源包括2010年1月至2021年9月之间进行的随机对照试验（RCT），术语为PRP，部分厚度的肩袖撕裂，关节内注射,肩峰下注射,和肌腱内注射。主要纳入标准：仅部分厚度的肩袖撕裂，注射前和注射后的功能结局评分，最少2个月随访时间,和非手术PRP注射。主要排除标准：PRP用作辅助治疗，全厚度肩袖撕裂，和治疗前的手术干预。
■共包括8个RCT,其利用注射到肩部的PRP用于PTRCT。研究按注射的位置进行分组，分为以下几个方面：1个肱骨关节，4肩峰下滑囊，和3个作为注射PRP的部位。关节内PRP显示手臂残疾改善46.2%(P<.05),肩膀,和12个月随访时的手部评分，但PRP与物理治疗相比无统计学差异.肩峰下注射，一项研究显示透明质酸和PRP与PRP之间没有统计学差异，但与生理盐水相比，两组在3、6和12个月时均有改善（P<0.05）。对于肌腱内注射，与干针法相比，两次注射PRP后3个月时，PRP的肩痛和残疾指数评分提高了66.1％（P<0.05），6个月时提高了71.6％（P<0.05）。另一项研究表明，与3个月时的皮质类固醇相比，联合使用LP-PRP注射的腱内和肩峰下滑囊在ASES评分上存在统计学上的显着差异。此外，在6个月的随访中，与肩峰下囊皮质类固醇组相比,PRP组的牛津肩评分显著改善53.8%vs31.7%(P<.01).
■根据我们对现有文献的回顾，当出现部分肩袖撕裂时,注射PRP的理想位置没有确凿的证据.尽管无论注射部位如何，PRP在诊断为PTRCT的患者中显示出改善的功能结果，需要更多的研究来确定PRP的最佳浓度，注射频率,以及在使用PRP进行PTRCT时，他们是理想的候选人。
■数据来源包括2010年1月至2021年9月之间进行的随机对照试验（RCT），术语为PRP，部分厚度的肩袖撕裂，关节内注射,肩峰下注射,和肌腱内注射。主要纳入标准：仅部分厚度的肩袖撕裂，注射前和注射后的功能结局评分，最少2个月随访时间,和非手术PRP注射。主要排除标准：PRP用作辅助治疗，全厚度肩袖撕裂，和治疗前的手术干预。
■共包括8个RCT,其利用注射到肩部的PRP用于PTRCT。研究按注射的位置进行分组，分为以下几个方面：1个肱骨关节，4肩峰下滑囊，和3个作为注射PRP的部位。关节内PRP显示手臂残疾改善46.2%(P<.05),肩膀,和12个月随访时的手部评分，但PRP与物理治疗相比无统计学差异.肩峰下注射，一项研究显示透明质酸和PRP与PRP之间没有统计学差异，但与生理盐水相比，两组在3、6和12个月时均有改善（P<0.05）。对于肌腱内注射，与干针法相比，两次注射PRP后3个月时，PRP的肩痛和残疾指数评分提高了66.1％（P<0.05），6个月时提高了71.6％（P<0.05）。另一项研究表明，与3个月时的皮质类固醇相比，联合使用LP-PRP注射的腱内和肩峰下滑囊在ASES评分上存在统计学上的显着差异。此外，在6个月的随访中，与肩峰下囊皮质类固醇组相比,PRP组的牛津肩评分显著改善53.8%vs31.7%(P<.01).
■根据我们对现有文献的回顾，当出现部分肩袖撕裂时,注射PRP的理想位置没有确凿的证据.尽管无论注射部位如何，PRP在诊断为PTRCT的患者中显示出改善的功能结果，需要更多的研究来确定PRP的最佳浓度，注射频率,以及在使用PRP进行PTRCT时，他们是理想的候选人。
