Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 6 Issue 7

Functional Outcome Assessment of Platelet Rich Plasma Versus Corticosteroid Injection in the Treatment of Rotator Cuff Injuries

Subitchan Ponnarasu1*, Poojalakshmi U2, Lokesh Sampath3, Anjali Ancy4 and Rohit Koganti5

1Assistant Professor, Department of Orthopaedics, Saveetha Medical College and Hospital, Kuthambakam, Chennai, Tamilnadu
2Final year MBBS Student, Saveetha medical college and hospital, Kuthambakam, Chennai, Tamilnadu
3Assistant Professor, Department of Orthopaedics, Saveetha Medical College and Hospital, Kuthambakam, Chennai, Tamilnadu
4Data Engineer, Chennai, Tamilnadu
5Final year MBBS Student, Saveetha Medical College and Hospital, Kuthambakam, Chennai, Tamilnadu

*Corresponding Author: Subitchan Ponnarasu, Assistant Professor, Department of Orthopaedics, Saveetha Medical College and Hospital, Kuthambakam, Chennai, Tamilnadu.

Received: December 13, 2022; Published: June 12, 2023

Abstract

Introduction:Conventionally local corticosteroid injection is the mainstay treatment in the management of rotator cuff tears. Intra-articular instillation of platelet rich plasma is an upcoming treatment modality in the management of rotator cuff injuries.

Aim: The aim of this study is to compare the functional outcome between platelet rich plasma and corticosteroid injection in rotator cuff injuries.

Methodology: 28 patients with rotator cuff tear who met the inclusion criteria were divided into 2 study groups by simple, random sampling. The first group of patients received 40mg of triamcinolone acetonide. The other group received PRP as intra articular injections. After the procedure the patients were evaluated immediately post intervention and at an interval of 3 weeks, 6 weeks and 12 weeks using the visual analogue scale for pain and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to assess the functional outcome.

Results: When compared to the baseline (pre intervention), both groups had statistically significant better VAS for pain and DASH score after injection. The PRP group experienced more pain immediately post intervention, but ultimately had better VAS and DASH score at 3, 6, and 12 weeks as compared to the corticosteroids group.

Conclusion: Platelet rich plasma appears to be more effective in the management of rotator cuff tears when compared to corticosteroids.

Keywords:Rotator Cuff Tear; Corticosteroids; Platelet Rich Plasma; PRP; Visual Analogue Scale for Pain (VAS); Disabilities of the Arm; Shoulder and Hand (DASH)

References

  1. Chaurasia BD. “Human anatomy”. CBS Publisher (2000).
  2. Wang C., et al. “Platelet-rich plasma injection vs corticosteroid injection for conservative treatment of rotator cuff lesions: A protocol for systematic review and meta-analysis”. Medicine7 (2021).
  3. Pasin T., et al. “Comparison of the effectiveness of platelet-rich plasma, corticosteroid, and physical therapy in subacromial impingement syndrome”. Archives of Rheumatology3 (2019): 308.
  4. Via AG., et al. “Clinical and biological aspects of rotator cuff tears”. Muscles, Ligaments and Tendons Journal2 (2013): 70.
  5. Sari A and Eroglu A. “Comparison of ultrasound-guided platelet-rich plasma, prolotherapy, and corticosteroid injections in rotator cuff lesions”. Journal of Back and Musculoskeletal Rehabilitation3 (2020): 387-396.
  6. Massy-Westropp N., et al. “Autologous blood injection and wrist immobilisation for chronic lateral epicondylitis”. Advances in Orthopedics (2012).
  7. Barreto RB., et al. “Platelet-rich plasma and corticosteroid in the treatment of rotator cuff impingement syndrome: randomized clinical trial”. Revista Brasileira de Ortopedia 54 (2019): 636-643.
  8. Von Wehren L., et al. “The effect of subacromial injections of autologous conditioned plasma versus cortisone for the treatment of symptomatic partial rotator cuff tears”. Knee Surgery, Sports Traumatology, Arthroscopy12 (2016): 3787-3792.
  9. Kothari SY and Venkataraman Srikumar NS. “Comparative efficacy of platelet rich plasma injection, corticosteroid injection and ultrasonic therapy in the treatment of periarthritis shoulder”. Journal of Clinical and Diagnostic Research: JCDR 5 (2011): RC15.
  10. Molini L., et al. “US guided corticosteroid injection into the subacromial-subdeltoid bursa: technique and approach”. Journal of Ultrasound1 (2012): 61-68.
  11. Zheng XQ., et al. “Nonsteroidal anti-inflammatory drugs versus corticosteroid for treatment of shoulder pain: a systematic review and meta-analysis”. Archives of Physical Medicine and Rehabilitation10 (2014): 1824-1831.
  12. Haraldsson BT., et al. “Corticosteroids reduce the tensile strength of isolated collagen fascicles”. The American Journal of Sports Medicine12 (2006): 1992-1997.
  13. Rutgers M., et al. “Cytokine profile of autologous conditioned serum for treatment of osteoarthritis, in vitro effects on cartilage metabolism and intra-articular levels after injection”. Arthritis Research and Therapy3 (2010): 1-1.
  14. Cervellin M., et al. “Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study”. Knee Surgery, Sports Traumatology, Arthroscopy1 (2012): 114-120.
  15. Bosch G., et al. “The effect of platelet-rich plasma on the neovascularization of surgically created equine superficial digital flexor tendon lesions”. Scandinavian Journal of Medicine and Science in Sports 4 (2011): 554-561.
  16. Heisterbach PE., et al. “Effect of BMP-12, TGF-beta1 and autologous conditioned serum on growth factor expression in Achilles tendon healing”. Knee Surgery, Sports Traumatology, Arthroscopy 10 (2012): 1907-1914.
  17. Lewis JS. “Rotator cuff tendinopathy: a model for the continuum of pathology and related management”. British Journal of Sports Medicine 13 (2010): 918-923.
  18. Nguyen RT., et al. “Applications of platelet-rich plasma in musculoskeletal and sports medicine: an evidence-based approach”. PM R3 (2011): 226-250.
  19. Cook JL and Purdam CR. “Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load induced tendinopathy”. British Journal of Sports Medicine 6 (2009): 409-416.
  20. Scarpone M., et al. “Effectiveness of platelet-rich plasma injection for rotator cuff tendinopathy: a prospective open-label study”. Global Advances in Integrative Medicine and Health2 (2013): 26-31.
  21. Rha DW., et al. “Comparison of the therapeutic effects of ultrasound-guided plateletrich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial”. Clinical Rehabilitation 2 (2013): 113-122.
  22. Kesikburun S., et al. “Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up”. The American Journal of Sports Medicine11 (2013): 2609-2616.
  23. Barber FA., et al. “Rotator cuff repair healing influenced by platelet-rich plasma construct augmentation”. Arthroscopy 8 (2011): 1029-1035.
  24. Antuna S., et al. “Platelet-rich fibrin in arthroscopic repair of massive rotator cuff tears: a prospective randomized pilot clinical trial”. Acta Orthopaedica Belgica 1 (2013): 25-30.
  25. Castricini R., et al. “Platelet-rich plasma augmentation for arthroscopic rotator cuff repair: a randomized controlled trial”. The American Journal of Sports Medicine2 (2011): 258-265.
  26. Weber SC., et al. “Platelet-rich fibrin matrix in the management of arthroscopic repair of the rotator cuff: a prospective, randomized, double blinded study”. The American Journal of Sports Medicine2 (2013): 263-270.
  27. Chahal J., et al. “The role of platelet rich plasma in arthroscopic rotator cuff repair: a systematic review with quantitative synthesis”. Arthroscopy11 (2012): 1718-1727.
  28. Malavolta EA., et al. “Platelet-rich plasma in rotator cuff repair: a prospective randomized study”. The American Journal of Sports Medicine10 (2014): 2446-2454.
  29. Zhang Q., et al. “Are platelet-rich products necessary during the arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis”. The American Journal of Sports Medicine4 (2013): 213-221.
  30. Rodeo SA., et al. “The effect of platelet-rich fibrin matrix on rotator cuff tendon healing: a prospective, randomized clinical study”. The American Journal of Sports Medicine 6 (2012): 1234-1241.
  31. Jo CH., et al. “Does platelet-rich plasma accelerate recovery after rotator cuff repair? A prospective cohort study”. The American Journal of Sports Medicine10 (2011): 2082-2090.
  32. Ruiz-Moneo P., et al. “Plasma rich in growth factors in arthroscopic rotator cuffrepair:a randomized, double-blind, controlled clinical trial”. Arthroscopy 1 (2013): 2-9.
  33. Bergeson AG., et al. “Effects of platelet-rich fibrin matrix on repair integrity of at-risk rotator cuff tears”. The American Journal of Sports Medicine2 (2012): 286-293.

Citation

Citation: Subitchan Ponnarasu., et al. “Functional Outcome Assessment of Platelet Rich Plasma Versus Corticosteroid Injection in the Treatment of Rotator Cuff Injuries”.Acta Scientific Orthopaedics 6.7 (2023): 17-22.

Copyright

Copyright: © 2023 Subitchan Ponnarasu., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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