PRP-Therapy for Tendinopathies of Rotator Cuff and Long Head of Biceps

Abstract

Relevance. Owing to its controlling action on the inflammatory process, pain-relieving and reparative effects the RPR-therapy became quite demanded for treatment of certain types of tendinopathies specified by prevalence of degenerative process and poor reparative potential. Purpose of the study — to evaluate the efficiency of PRP-therapy in patients with tendinopathies of rotator cuff (RC) long head of biceps (LHB) tendons. Material and Methods. The paper presents the results of two-center prospective study for application of autologous platelet rich plasma in treatment of 122 patients: 53 men and 69 women aging 46.8±6.8 years who suffered RC tendinopathy (66%), subacromial impingement syndrome and RC tendinopathy (17%) and LHB tendinopathy (17%). Treatment outcomes were evaluated in 1, 3 and 6 months after PRP-therapy using various scales — VAS, UCLA , DASH, — and instrumental examination methods (US, MRI). Results. The authors observed statistically significant improvement in pain and functional scores in all three groups as compared to reported scores prior to PRP-therapy during 6 months follow up. During this period of evaluation, the scores of UCLA and DASH in patients with RC tendinopathy improved at 8.6 and 36.4 points, with subacromial impingement syndrome and RC tendinopathy — at 9.6 and 38.8 points, with LHB tendinopathy — at 11.5 and 44.1 point, respectively. The most notable reduction of pain syndrome by VAS was achieved in treatment of LHB tendinopathy (at 5.4 points) and RC tendinopathy (at 5.2 point). The highest average scores of satisfaction with treatment outcomes were reported in patients with RC tendinopathy (2.3) and LHB tendinopathy (2.2). MRI and ultrasound examinations after PRP-therapy demonstrated improved structure of RC and LHB tendons — decreased or eliminated swelling, areas of hypoechoic signal. Conclusion. PRP-therapy in patients with RC and LHB tendons and with subacromial impingement syndrome with RC tendinopathy significantly reduces severity of pain and improved the shoulder joint function with positive dynamics during 6 months follow up.