Abstract
Introduction:Rotator cuff tendinitis has been treated using various methods including physiotherapy, steroid injections and recently platelet rich plasma (PRP). Most of these methods aim at giving symptomatic relief rather than addressing the pathology. There is no clear consensus over the benefit of using PRP for tendinitis. We decided to do a prospective clinical study to demonstrate the efficacy of PRP and study the functional outcome in the treatment of rotator cuff tendinopathy.Material and Methods:Patients with shoulder pain for more than three months not responding to NSAIDs or physiotherapy with a diagnosis of rotator cuff tendinitis, confirmed by MRI, were included in the study. Patients with rotator cuff tear or any other shoulder pathology were excluded. We included a total of 30 patients who received 5ml of landmark guided PRP injection in the subacromial space followed by a six-week exercise program. Patients were followed-up at 3, 6 and 12 weeks. and were assessed clinically using the VAS, SPADI and Constant and Murley Score.Results:VAS score of patients improved from a pre injection score of 7.4 to a score of 1.9 in the 12th week. The mean SPADI score and Constant score improved from a pre injection score of 73.33 and 39.57 to a post injection score of 18.1 and 86.47, respectively.Conclusion:Platelet Rich Plasma injections showed good to excellent early results, in patients with rotator cuff tendinopathy with improvement in VAS, SPADI and Constant scores.
Highlights
INTRODUCTIONAnatomical location of rotator cuff muscles and its biomechanics predisposes it to degenerative changes and because of this the rotator cuff is susceptible to tendinopathy, especially in the presence of risk factors like overuse, ageing, trauma, metabolic disorders or obesity[1]
Rotator cuff tendinitis has been treated using various methods including physiotherapy, steroid injections and recently platelet rich plasma (PRP)
We decided to do a prospective clinical study to demonstrate the efficacy of PRP and to evaluate the functional outcome in the treatment of rotator cuff tendinopathies
Summary
Anatomical location of rotator cuff muscles and its biomechanics predisposes it to degenerative changes and because of this the rotator cuff is susceptible to tendinopathy, especially in the presence of risk factors like overuse, ageing, trauma, metabolic disorders or obesity[1]. Corticosteroid injections are uselful in only acute and subacute tendinits and some reports have said that they cause an inhibition in collagen synthesis which may lead on to tendon failure[4] The inadequacy of these therapies in some cases calls for new research. Platelet Rich Plasma (PRP) therapy is the readily available autologous “bedside” injectable orthobiologic, which is gaining widespread use. It increases healing potential, mediates inflammatory processes and reduces pain through the release of mediating amines. Peritendinous injection of PRP acts by limiting damage and promotes healing mechanisms in the tendons involved It acts by its anti-inflammatory, anabolic and milieu interior altering mechanism through release of growth factors present in the platelets[8]. We decided to do a prospective clinical study to demonstrate the efficacy of PRP and to evaluate the functional outcome in the treatment of rotator cuff tendinopathies
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