Introduction
Multiple studies have been done using PRP (platelet rich plasma) injection in and around the shoulder joint e.g frozen shoulder, rotator cuff tear (RCT), calcific tendinitis, sub-acromial injections. The results have been favorable overall with most studies reporting improvement in terms of pain and function. There has been only one study involving two patients, where PRP injections were used for labrum healing in Bankart lesion in shoulder dislocation patients. The authors had reported functional improvement in preliminary results, but those cannot be used to draw any specific conclusion. Hence, we designed this study with the hypothesis that PRP injection into the labrum repair will produce better healing and improved functional outcome in patients of recurrent shoulder dislocation treated with arthroscopic repair.
Methods
Patients of recurrent shoulder dislocation who were operated arthroscopically, were separated into two groups: Group 1 (cases): administered double spin LR (Leukocyte rich)-PRP injection; Group 2 (controls): not received the PRP injection. Rest all treatment was similar in both the groups. The injection was given arthroscopically at the labrum-bone interface after repair was completed. Follow up scoring (ASES, DASH & Constant) and MRI were done at 6 months.
Results
A total of 40 patients were included in this study, 20 in group I (cases) and 20 in group II (controls). mean age was 26±6 years. 36 patients (90%) were male (19 in group II, 17 in group I) and 4 patients (10%) were female (1 in group II, 3 in group I). 25 had right side shoulder affected (62.5%) and 15 had left side shoulder involvement (37.5%). Both the groups were comparable with no statistically significant difference in the age, gender and site distribution. All the three scores showed improvement at followup evaluation inside the groups and the increase had high statistical significance (p <0.001). On comparing the increase in individual scores between the groups, the improvement was more in group I, the difference was statistically significant for the ASES and DASH scores (p<0.05). The CSS was also higher in group I (93.2 ?2.8) at followup as compared to group II (91.5 ? 2.7), but the difference did not reach statistical significance (p = 0.063). Followup MRI evaluation showed improvement in Labral height (LH) (p<0.05), Labrum height glenoid index (LGHI) (p>0.05), and Labral slope (LS) (p<0.05) in both the groups, the increase was more in group I as compared to group II. All the three radiological measurements were significantly higher in group 1 vs group 2, with statistically significant difference achieved for labral height and labral slope (p<0.05).
Conclusion
The PRP injection at the labrum-bone interface was found to provide better healing response in labrum and better functional outcomes at 6 months followup in patients with arthroscopic labrum repair.