Abstract
BackgroundWe compared the clinical course of rotator cuff tears between rotator cuff exercise and bone marrow aspirate concentration (BMAC)-platelet rich plasma (PRP) injection to identify the therapeutic effects of BMAC-PRP on partial tear of the rotator cuff tendon.MethodsTwenty-four patients with partial tear of the rotator cuff tendon participated in this study. Twelve patients underwent extraction of BMACs and PRP and received the injection of BMAC-PRP at the tear site under ultrasound guidance. Twelve patients in the control group were asked to perform the rotator cuff exercise for 3 months. Visual analog scale (VAS) and manual muscle test (MMT) scores of the supraspinatus muscle were measured, and the American Shoulder and Elbow Surgeons (ASES) score was recorded before, 3 weeks, and 3 months after injection. Tear size was measured by the greatest longitudinal tear length.ResultsThe change in the VAS differed between groups at 3 months (P = 0.039) but not at 3 weeks (P = 0.147). The ASES scores in the BMAC-PRP group changed from 39.4 ± 13.0 to 54.5 ± 11.5 at 3 weeks and 74.1 ± 8.5 at 3 months while those in the control group changed from 45.9 ± 12.4 to 56.3 ± 12.3 at 3 weeks (P = 0.712) and 62.2 ± 12.2 at 3 months (P = 0.011). The tear size decreased at 3 weeks or 3 months after the BMAC-PRP injection but was not significantly different from that in the control group.ConclusionsBMAC-PRP improved pain and shoulder function in patients with partial tear of the rotator cuff tendon.Trial registrationThe patients were registered in the institutional board registry of Samsung Medical Center (registry number 2014-07-173).
Highlights
We compared the clinical course of rotator cuff tears between rotator cuff exercise and bone marrow aspirate concentration (BMAC)-platelet rich plasma (PRP) injection to identify the therapeutic effects of bone marrow aspirate concentrates (BMACs)-PRP on partial tear of the rotator cuff tendon
Our study showed that BMAC-PRP injection was associated with improved Visual analog scale (VAS) and ASES scores at 3 months after injection as compared to the control group, while the change in the tear size and manual muscle test (MMT) did not differ between groups
Further studies with a larger sample size will be necessary to clarify the therapeutic effects of BMAC-PRP on rotator cuff tears
Summary
We compared the clinical course of rotator cuff tears between rotator cuff exercise and bone marrow aspirate concentration (BMAC)-platelet rich plasma (PRP) injection to identify the therapeutic effects of BMAC-PRP on partial tear of the rotator cuff tendon. Rotator cuff tendon tear is a common shoulder problem with a prevalence of about 21% in the general population [1]. Rotator cuff tendon tear is treated by non-surgical and surgical methods. Non-surgical treatments are rotator cuff strengthening exercise, oral medication, and corticosteroid injection. All of these focus on symptomatic treatments rather than restoration of shoulder function and prevention of the progression of tears. Rotator cuff stretching and strengthening exercise can improve shoulder function, but the protocols are not standardized and its effect is not evident yet [5]. Surgical repair of the torn rotator cuff can restore shoulder function and prevent the progression of
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