Efficiency of local injections of platelet-rich plasma in shoulder impingement syndrome
https://doi.org/10.14412/1996-7012-2019-4-61-65
Abstract
Chronic shoulder pain caused by shoulder impingement syndrome (SIS) is a common pathology that leads to worse quality of life and disability. The local administration of platelet-rich plasma (PRP) is a promising treatment for SIS.
Objective: to evaluate the efficiency of subacromial injection of PRP in chronic shoulder pain caused by SIS.
Patients and methods. The investigation enrolled 30 patients (13 women and 17 men; mean age, 45.8±14.1 years) with chronic shoulder pain lasting ≥3 months after rotator tendons injury confirmed by ultrasound and/or magnetic resonance imaging and inefficiency of previously medical therapy. All the patients received three subacromial injections of 5 ml of PRP at a 7-day interval. The investigators assessed the course of pain during movement (100-mm visual analogue scale (VAS)) and functional ability according to the ASES and CSC questionnaires at baseline and 1, 3 and 6 months after treatment.
Results and discussion. During the treatment, there was a considerable improvement in all indicators. At baseline and 1 and 3 months, the mean pain severity measured on VAS was 49.3±10.3, 32.4±21.3, and 20.6±21.3 mm, respectively; in this case, the positive effect persisted at 6-month follow-up: 10 [0; 30] mm (p<0.001). The mean ASES values were 59.5±11.5, 75.9±17.4, 82.6±17.6, and 86.7±17.1 (p<0.001) and the mean CSC scores were 72.3±14.1, 81.0±16.2, 88.5±16.1, and 92.8±16.2 (p<0.001), respectively. There were no serious adverse reactions.
Conclusion. Subacromial injection of PRP is an effective and safe treatment for chronic shoulder pain associated with SIS.
About the Authors
V. A. NesterenkoRussian Federation
Vadim Andreevich Nesterenko
34A, Kashirskoe Shosse, Moscow 115522
A. E. Karateev
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
E. I. Byalik
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
M. A. Makarov
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
S. A. Makarov
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
V. E. Byalik
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
M. R. Nurmukhametov
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
I. A. Fedotov
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
References
1. Nasonov EL, redaktor. Rossiiskie klinicheskie rekomendatsii. Revmatologiya [Russian clinical guidelines. Rheumatology]. Moscow: GEOTAR-Media; 2017. 446 p.
2. Garving C, Jakob S, Bauer I, et al. Impingement Syndrome of the Shoulder. Dtsch Arztebl Int. 2017 Nov 10; 114(45): 765-776. doi: 10.3238/arztebl.2017.0765.
3. Cunningham G, Lädermann A. Redefining anterior shoulder impingement: a literature review. Int Orthop. 2018 Feb; 42(2):359-366. doi: 10.1007/s00264-017-3515-1. Epub 2017 Jun 6.
4. Millar NL, Hueber AJ, Reilly JH, et al. Inflammation is present in early human tendinopathy. Am J Sports Med. 2010 Oct;38 (10):2085-91. doi: 10.1177/0363546510372613. Epub 2010 Jul 1.
5. Gotoh M, Hamada K, Yamakawa H, et al. Interleukin-1-induced glenohumeral synovitis and shoulder pain in rotator cuff diseases. J Orthop Res. 2002 Nov; 20(6):1365-71.
6. Voloshin I, Gelinas J, Maloney MD, et al. Proinflammatory cytokines and metalloproteases are expressed in the subacromial bursa in patients with rotator cuff disease. Arthroscopy. 2005 Sep; 21(9):1076.e1-1076.e9.
7. Nasonov EL, Yakhno NN, Karateev AE, et al. General principles of treatment for musculoskeletal pain: interdisciplinary consensus. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2016;54(3):247-65. (In Russ.). doi: 0.14412/1995-4484-2016-247-265
8. Codsi M, Howe CR. Shoulder Conditions: Diagnosis and Treatment Guideline. Phys Med Rehabil Clin N Am. 2015 Aug; 26(3): 467-89. doi: 10.1016/j.pmr.2015.04.007.
9. Dong W, Goost H, Lin XB, et al. Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine (Baltimore). 2015 Mar; 94(10):e510. doi: 10.1097/MD.0000000000000510.
10. Wittich CM, Ficalora RD, Mason TG, et al. Musculoskeletal Injection. Mayo Clin Proc. 2009 Sep;84(9):831-6; quiz 837. doi: 10.1016/S0025-6196(11)60493-X.
11. Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010 Nov 20; 376(9754):1751-67.
12. Dean BJ, Lostis E, Oakley T, et al. The risks and benefits of glucocorticoid treatment for tendinopathy: a systematic review of the effects of local glucocorticoid on tendon. Semin Arthritis Rheum. 2014 Feb; 43(4):570-6. doi: 10.1016/j.semarthrit.2013.08.006. Epub 2013 Sep 26.
13. Southworth TM, Naveen NB, Nwachukwu BU, et al. Orthobiologics for Focal Articular Cartilage Defects. Clin Sports Med. 2019 Jan;38(1):109-122. doi: 10.1016/j.csm.2018.09.001.
14. Riboh JC, Saltzman BM, Yanke AB, et al. Effect of Leukocyte Concentration on the Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis. Am J Sports Med. 2016 Mar; 44(3):792-800. doi: 10.1177/0363546515580787. Epub 2015 Apr 29.
15. Andia I, Sanchez M, Maffulli N. Joint pathology and platelet-rich plasma therapies. Expert Opin Biol Ther. 2012 Jan; 12(1):7-22. doi: 10.1517/14712598.2012.632765
16. Andia I, Maffulli N. Platelet-rich plasma for managing pain and inflammation in osteoarthritis. Nat Rev Rheumatol. 2013 Dec; 9(12):721-30. doi: 10.1038/nrrheum.2013.141. Epub 2013 Oct 1.
17. Murphy MB, Blashki D, Buchanan RM, et al. Adult and umbilical cord bloodderived platelet-rich plasma for mesenchymal stem cell proliferation, chemotaxis, and cryopreservation. Biomaterials. 2012 Jul;33(21): 5308-16. doi: 10.1016/j.biomaterials.2012.04.007. Epub 2012 Apr 28.
18. Anitua E, Sanchez M, de la Fuente M, et al. Plasma rich in growth factors (PRGF-Endoret) stimulates tendon and synovial fibroblasts migration and improves the biological properties of hyaluronic acid. Knee Surg Sports Traumatol Arthrosc. 2012 Sep;20(9): 1657-65. doi: 10.1007/s00167-011-1697-4. Epub 2011 Oct 11.
19. Krüger JP, Hondke S, Endres M, et al. Human platelet-rich plasma stimulates migration and chondrogenic differentiation of human subchondral progenitor cells. J Orthop Res. 2012 Jun;30(6):845-52. doi: 10.1002/jor.22005. Epub 2011 Nov 4.
20. Mlynarek RA, Kuhn AW, Bedi A. Platelet-Rich Plasma (PRP) in Orthopedic Sports Medicine. Am J Orthop (Belle Mead NJ). 2016 Jul-Aug;45(5):290-326.
21. McCarrel T, Fortier L. Temporal growth factor release from plateletrich plasma, trehalose lyophilized platelets, and bone marrow aspirate and their effect on tendon and ligament gene expression. J Orthop Res. 2009 Aug; 27(8):1033-42. doi: 10.1002/jor.20853.
22. McCarrel TM, Minas T, Fortier LA. Optimization of leukocyte concentration in platelet-rich plasma for the treatment of tendinopathy. J Bone Joint Surg Am. 2012 Oct 3; 94(19):e143(1-8). doi: 10.2106/JBJS.L.00019.
23. Boswell SG, Schnabel LV, Mohammed HO, et al. Increasing platelet concentrations in leukocyte-reduced plateletrich plasma decrease collagen gene synthesis in tendons. Am J Sports Med. 2014 Jan;42(1): 42-9. doi: 10.1177/0363546513507566. Epub 2013 Oct 17.
24. Andia I, Abate M. Platelet-rich plasma: underlying biology and clinical correlates. Regen Med. 2013 Sep;8(5):645-58. doi: 10.2217/rme.13.59.
25. Kothari SY, Srikumar V, Singh N. Comparative Efficacy of Platelet Rich Plasma Injection, Corticosteroid Injection and Ultrasonic Therapy in the Treatment of Periarthritis Shoulder. J Clin Diagn Res. 2017 May; 11(5):RC15-RC18. doi: 10.7860/JCDR/2017/17060.9895
26. Smid P, Hart R, Komzak M, et al. Treatment of the Shoulder Impingement Syndrome with PRP Injection. Acta Chir Orthop Traumatol Cech. 2018;85(4):261-265.
27. Hurley ET, Lim Fat D, Moran CJ, Mullett H. The Efficacy of Platelet-Rich Plasma and Platelet-Rich Fibrin in Arthroscopic Rotator Cuff Repair: A Metaanalysis of Randomized Controlled Trials. Am J Sports Med. 2019 Mar;47(3):753-761. doi: 10.1177/0363546517751397. Epub 2018 Feb 21.
28. Schneider A, Burr R, Garbis N, Salazar D. Platelet-rich plasma and the shoulder: clinical indications and outcomes. Curr Rev Musculoskelet Med. 2018 Dec;11(4): 593-597. doi: 10.1007/s12178-018-9517-9.
29. Hussain N, Johal H, Bhandari M. An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature. SICOT J. 2017;3:57. doi: 10.1051/sicotj/2017036. Epub 2017 Oct 9.
30. Han C, Na Y, Zhu Y, et al. Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2019 Jun 20;14(1):183. doi: 10.1186/s13018-019-1207-9.
Review
For citations:
Nesterenko VA, Karateev AE, Byalik EI, Makarov MA, Makarov SA, Byalik VE, Nurmukhametov MR, Fedotov IA. Efficiency of local injections of platelet-rich plasma in shoulder impingement syndrome. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2019;13(4):61-65. (In Russ.) https://doi.org/10.14412/1996-7012-2019-4-61-65