The Search for Rotator Cuff Tear Treatment
Reported February 22, 2011
(Ivanhoe Newswire) -- The shoulder is a complex mechanism of intertwining bones,
ligaments, joints, muscles, and tendons. Rotator cuff tears in one or more of
those tendons are among the most common conditions affecting the shoulder, and
improving the healing process subsequent to a rotator cuff tendon repair
continues to be problematic for orthopedic surgeons across the world. In fact,
researchers discovered that one of the most recent tools for healing injuries,
platelet-rich plasma (PRP), does not actually make that big of a big difference.
"Our study on 79 patients who received platelet-rich plasma with a fibrin matrix
(PRFM) demonstrated no real differences in healing in a tendon-to-bone rotator
cuff repair,” which study author, Scott Rodeo, MD of New York City's Hospital
for Special Surgery, was quoted as saying. “In fact, this preliminary analysis
suggests that the PRFM, as used in this study, may have a negative effect on
healing. However, this data should be viewed as preliminary, and further study
is required."
The randomized trial divided 79 participating patients into one of two groups:
the first received the PRFM where as the second did not. Standardized rotator
cuff repair techniques were implemented for all of the patients along with
post-operative rehabilitation protocols. The tendon healing was moreover
evaluated via ultrasound at six and 12 weeks post-operation. Ultrasound was
additionally used to establish blood flow in various areas of the repaired
tendon. The researchers also observed shoulder movement outcome scales as well
as strength measurements.
Researchers believe there may be a number of reasons for the lack of response in
healing, including inconsistency in the way platelets are recovered, platelet
activation in addition to the mechanisms for the way the PRFM reacts with the
tendon cells. The study furthermore was unable to document the number of
platelets truly delivered to patients who received the PRFM.
"Additional research needs to be performed to figure out the mechanisms for why
PRP is successful in healing certain areas of the body and not others. With more
study we will continue to learn new procedures for improving orthopedic surgery
outcomes," concludes Rodeo.
SOURCE: American Orthopaedic Society for Sports Medicine's Specialty Day in San
Diego, February 21, 2011
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