Summary

The use of Endoret® leads to a progressive reduction in the pain and improve the quality of life, and function of the patient at 12 months of follow-up.

Abstract

Introduction

Rotator cuff tendinopathy is a common cause of shoulder pain and disability. The incidence in active population reported is 14 to 18%. Rotator Cuff injuries are more common in women, with a peak between 50 to 60 years. The initial management of rotator cuff tendinopathy is mainly conservative and focuses on causing the inflammatory process to stop using physical therapy, corticosteroid injection, nosteroid anti-inflammatory drugs, approximately 60% of patients are satisfied with treatment.
There are few previous studies that have evaluated the effect of PRP injection in rotator cuff injury. PRP treatment aims to regenerate damaged tissues. Stimulating tissue regeneration mechanisms to promote migration, proliferation and differentiation of cells. The aim of this study is to determine the use and efficacy of Platelet-Rich Plasma treatment in patients with rotator cuff tendinopathy.

Methods

We performed a double-blind randomized controlled clinical trial. 84 patients were included. Patients will be randomized into two homogeneous groups. Using the Endoret® system for generating PRP, patients in study group underwent 3 subacromial injections of PRP under ultrasound guidance every 21 days. Patients in the placebo group were injected in the same manner with corticosteroids and local anesthetic. Following the injection, all patients undertook a standardized physical therapy. To assess the results, we used specific test for shoulder pathology. QuickDASH (disabilities of the arm, shoulder and hand, QD). Constant (CS) and UCLA scale (US). Patients were clinically re-evaluated at 3, 6 and 12 months post-injection.

Results

The mean age was 54.55 years. 61% of women and 39% men were included. 29.7% were left shoulder and rights 70.3%. There were no statistically significant differences between groups at baseline. Both 3, and at 6 months follow-up of patients treated with PRP presented significant clinical improvement in all the variables analyzed. At the end of follow-up patients of the study group present a 78% of improvement respect to 28% of the control group in Constant scale. In the study group, pain decreased and functionality improved significantly, CS 32.65 ± 1.97, US 14.25 ± 0.78, QD 35.92 ± 3; in control group the difference was less CS 12.47 ± 2.85, US 7.27 ± 1.01, QD 22.43 ± 3,58.We have presented 5 cases of withdrawal, two patients of control group that were allergic to corticosteroids, one patient with rotator cuff tear and two significant pain during injection.

Discussion

AND CONCLUSION.


In the last years there have been various studies with relevant results. Preliminary results indicate that a single PRP injection lead to improvements in pain, function, in patients with rotator cuff tendinopathy. However, there have been studies that question the usefulness of PRP in tendon injuries, not only in Achilles tendon injuries, but also in tendinopathy of the rotator cuff. The use of Endoret® leads to a progressive reduction in the pain and improve the quality of life, and function of the patient at 12 months of follow-up. These findings suggest that platelet-rich plasma injections is safe and useful for rotator cuff tendinopathy