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THE COMPARISON OF DEXTROSE PROLOTHERAPY AND PLATELLET RICH PLASMA IN PATIENTS WITH ROTATOR CUFF TEARS

Year 2020, Volume: 14 Issue: 1, 4 - 7, 30.04.2020

Abstract

Objective: To compare the effect of dextrose prolotherapy and platellet rich plasma on pain, functionality levels in patients with
rotator cuff tears.
Materials/Methods: Patients with ultrasound-confirmed rotator cuff tear were randomly divided into two groups as follows; group
I (n=15) (the injection of dextrose solution over tear) and the group II (n=15) (the injection of platelet rich plasma over tear). Outcome
measures including visual analog scale (VAS) (pain at rest, during activity and at night), shoulder range of motions (ROMs),
shoulder disability questionnaire (SDQ) and The University of California-Los Angeles scale (UCLA) were evaluated before (baseline)
and after the treatment (4th week).
Results: The 30 participants had shoulder pain (6.6±2.3) for 4.2±1.6 months. Demographic and baseline clinical characteristics
of the groups were similar between the groups (p> 0.05). Within each group, significant improvements were observed in all clinical
variables (p< 0.001). There was no significant differences in the changes in outcome scores (VAS, SDQ, UCLA) (according to baseline
values) between the groups ( p<0.05). But Group II was superior to Group I in the changes in ROM.
Conclusion: We found a significant improvement in terms of pain, ROM and functionality in both groups. In participants with rotator
cuff tear, the injection of platellet rich plasma over tear area resulted in superior ROM improvement compared with dextrose injection.
The injection of platellet rich plasma may improve upon dextrose injection for patients with shoulder pain.

References

  • 1. Ryu K, Ko D, Lim G, Kim E, Lee SH. Ultrasound-Guided Prolotherapy with Polydeoxyribonucleotide for Painful Rotator Cuff Tendinopathy. Pain Res Manag. 2018;2018:8286190. 2. Mahon HS, Christensen JE, Brockmeier SF. Shoulder Rotator Cuff Pathology: Common Problems and Solutions. Clin Sports Med. 2018;37(2):179-196 3. Bertrand H, Reeves KD, Bennett CJ, Bicknell S, Cheng AL. Dextrose Prolotherapy Versus Control Injections in Painful Rotator Cuff Tendinopathy. Arch Phys Med Rehabil. 2016;97(1):17-25. 4. Ko JY, Wang FS, Huang HY, Wang CJ, Tseng SL, Hsu C. Increased IL-1beta expression and myofibroblast recruitment in subacromial bursa is associated with rotator cuff lesions with shoulder stiffness. J Orthop Res. 2008;26(8):1090-7. 5. Lee DH, Kwack KS, Rah UW, Yoon SH. Prolotherapy for Refractory Rotator Cuff Disease: Retrospective Case-Control Study of 1-Year Follow-Up. Arch Phys Med Rehabil. 2015;96(11):2027-32. 6. Seven MM, Ersen O, Akpancar S, Ozkan H, Turkkan S, Yıldız Y, Koca K. Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions. Orthop Traumatol Surg Res. 2017;103(3):427-433. 7. Sengodan VC, Kurian S, Ramasamy R. Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma. J Clin Imaging Sci. 2017;7:32. 8. Saltzman BM, Jain A, Campbell KA, Mascarenhas R, Romeo AA, Verma NN, et al. Does the use of platelet-rich plasma at the time of surgery improve clinical outcomes in arthroscopic rotator cuff repair when compared with control cohorts? A systematic review of meta-analyses. Arthroscopy 2016;32:906-18. 9. Randelli P, Arrigoni P, Ragone V, Aliprandi A, Cabitza P. Platelet rich plasma in arthroscopic rotator cuff repair: A prospective RCT study, 2-year followup. J Shoulder Elbow Surg 2011;20:518-28. 10. Veronesi F, Borsari V, Contartese D, Xian J, Baldini N, Fini M. The clinical strategies for tendon repair with biomaterials: A review on rotator cuff and Achilles tendons.J Biomed Mater Res B Appl Biomater. 2019 Nov 30. [Epub ahead of print] 11. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17:45–56. 12. Hayes K, Walton JR, Szomor ZL, Murrell GA. Reliability of five methods for assessing shoulder range of motion. Aust J Physiother 2001;47:289-294. 13. Windt D, Heijden G, Winter AF. The responsiveness of the shoulder disability questionnaire. Ann Rheum Dis 1998;57:82-87. 14. Matsen FA, Smith KL. Effectiveness Evaluation and the Shoulder. In: Rockwood CA, Matsen FA (eds) The shoulder, 2nd edn. W.B. Saunders, Philadelphia. 1998. pp1313-1340. 15. Ryan M, Wong A, Taunton J. Favorable outcomes after sonographically guided intratendinous injection of hyperosmolar dextrose for chronic insertional and midportion Achilles tendinosis. Am J Roentgenol. 2010;194(4):1047-1053. 16. Ryan M, Wong A, Rabago D, Lee K, Taunton J. Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy: a pilot study. Br J Sports Med. 2011;45(12):972-977.

ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Year 2020, Volume: 14 Issue: 1, 4 - 7, 30.04.2020

Abstract

Amaç: Rotator manşet yırtığı olan hastalarda dekstroz proloterapisiyle trombositten zengin plazma uygulamasının ağrı, fonksiyonellik
üzerine etkisini karşılaştırmak.
Matreyal ve Method: Ultrasonla rotator manşet yırtığı olan hastalar iki gruba randomize edildi: Grup I yırtık üzerine dekstroz proloterapi
enjeksiyonu (n=15), Grup II yırtık üzerine trombositten zengin plazma uygulaması (n=15). Sonuçlar ağrı için vizüel analog
skala (VAS) (istirahatte, aktivite sırasında ve gece), omuz eklem hareket açıklığı ölçümü (EHA), fonksiyonellik için de omuz özürlülük
ölçütü (OÖÖ) ve The University of California-Los Angeles skalası (UCLA) kullanılarak tedavi öncesi ve tedavi sonrası 4. hafta bitiminde
değerlendirildi.
Sonuçlar: 30 katılımcının omuz ağrısı ortalaması 6.6±2.3, ağrsı süresi ortalaması 4.2±1.6 idi. Demografik ve klinik özelliklerin ilk
değerlendirmeleri gruplar arası benzerdi (p> 0.05). Grup içi tüm klinik parametrelerde düzelme vardı (p< 0.001). İlk ve son değerlendirme
arasındaki farklar kıyaslandığında VAS, OÖÖ, UCLA değerlendirmelerinde iki grup arasında fark yokken, Grup II’deki EHA
değişiminin Grup I’de istatistiksel olarak anlamlı düzeyde daha iyi olduğu gözlendi ( p<0.05).
Sonuç: Her iki grupta da ağrı, EHA ve fonksiyonellikte belirgin düzelme gözlendi. Ağrı, fonksiyonellik açısından iki uygulamanın etkinliği
benzerken EHA’daki düzelme açısından trombositten zengin plazma uygulanan grupta dektroz proloterapisi uygulanan gruptan daha
belirgin düzelme izlenmişti. Onun için rotator manşette yırtığı olan hastalarda trombositten zengin plazma uygulaması tercih edilebilir.

References

  • 1. Ryu K, Ko D, Lim G, Kim E, Lee SH. Ultrasound-Guided Prolotherapy with Polydeoxyribonucleotide for Painful Rotator Cuff Tendinopathy. Pain Res Manag. 2018;2018:8286190. 2. Mahon HS, Christensen JE, Brockmeier SF. Shoulder Rotator Cuff Pathology: Common Problems and Solutions. Clin Sports Med. 2018;37(2):179-196 3. Bertrand H, Reeves KD, Bennett CJ, Bicknell S, Cheng AL. Dextrose Prolotherapy Versus Control Injections in Painful Rotator Cuff Tendinopathy. Arch Phys Med Rehabil. 2016;97(1):17-25. 4. Ko JY, Wang FS, Huang HY, Wang CJ, Tseng SL, Hsu C. Increased IL-1beta expression and myofibroblast recruitment in subacromial bursa is associated with rotator cuff lesions with shoulder stiffness. J Orthop Res. 2008;26(8):1090-7. 5. Lee DH, Kwack KS, Rah UW, Yoon SH. Prolotherapy for Refractory Rotator Cuff Disease: Retrospective Case-Control Study of 1-Year Follow-Up. Arch Phys Med Rehabil. 2015;96(11):2027-32. 6. Seven MM, Ersen O, Akpancar S, Ozkan H, Turkkan S, Yıldız Y, Koca K. Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions. Orthop Traumatol Surg Res. 2017;103(3):427-433. 7. Sengodan VC, Kurian S, Ramasamy R. Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma. J Clin Imaging Sci. 2017;7:32. 8. Saltzman BM, Jain A, Campbell KA, Mascarenhas R, Romeo AA, Verma NN, et al. Does the use of platelet-rich plasma at the time of surgery improve clinical outcomes in arthroscopic rotator cuff repair when compared with control cohorts? A systematic review of meta-analyses. Arthroscopy 2016;32:906-18. 9. Randelli P, Arrigoni P, Ragone V, Aliprandi A, Cabitza P. Platelet rich plasma in arthroscopic rotator cuff repair: A prospective RCT study, 2-year followup. J Shoulder Elbow Surg 2011;20:518-28. 10. Veronesi F, Borsari V, Contartese D, Xian J, Baldini N, Fini M. The clinical strategies for tendon repair with biomaterials: A review on rotator cuff and Achilles tendons.J Biomed Mater Res B Appl Biomater. 2019 Nov 30. [Epub ahead of print] 11. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17:45–56. 12. Hayes K, Walton JR, Szomor ZL, Murrell GA. Reliability of five methods for assessing shoulder range of motion. Aust J Physiother 2001;47:289-294. 13. Windt D, Heijden G, Winter AF. The responsiveness of the shoulder disability questionnaire. Ann Rheum Dis 1998;57:82-87. 14. Matsen FA, Smith KL. Effectiveness Evaluation and the Shoulder. In: Rockwood CA, Matsen FA (eds) The shoulder, 2nd edn. W.B. Saunders, Philadelphia. 1998. pp1313-1340. 15. Ryan M, Wong A, Taunton J. Favorable outcomes after sonographically guided intratendinous injection of hyperosmolar dextrose for chronic insertional and midportion Achilles tendinosis. Am J Roentgenol. 2010;194(4):1047-1053. 16. Ryan M, Wong A, Rabago D, Lee K, Taunton J. Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy: a pilot study. Br J Sports Med. 2011;45(12):972-977.
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Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research
Authors

Şule Şahin This is me

Elif Umay Altaş This is me

Publication Date April 30, 2020
Published in Issue Year 2020 Volume: 14 Issue: 1

Cite

APA Şahin, Ş., & Umay Altaş, E. (2020). ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI. Bilimsel Tamamlayıcı Tıp Regülasyon Ve Nöral Terapi Dergisi, 14(1), 4-7.
AMA Şahin Ş, Umay Altaş E. ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI. BARNAT. April 2020;14(1):4-7.
Chicago Şahin, Şule, and Elif Umay Altaş. “ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI”. Bilimsel Tamamlayıcı Tıp Regülasyon Ve Nöral Terapi Dergisi 14, no. 1 (April 2020): 4-7.
EndNote Şahin Ş, Umay Altaş E (April 1, 2020) ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi 14 1 4–7.
IEEE Ş. Şahin and E. Umay Altaş, “ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI”, BARNAT, vol. 14, no. 1, pp. 4–7, 2020.
ISNAD Şahin, Şule - Umay Altaş, Elif. “ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI”. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi 14/1 (April 2020), 4-7.
JAMA Şahin Ş, Umay Altaş E. ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI. BARNAT. 2020;14:4–7.
MLA Şahin, Şule and Elif Umay Altaş. “ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI”. Bilimsel Tamamlayıcı Tıp Regülasyon Ve Nöral Terapi Dergisi, vol. 14, no. 1, 2020, pp. 4-7.
Vancouver Şahin Ş, Umay Altaş E. ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI. BARNAT. 2020;14(1):4-7.