Sodium Hyaluronate and Platelet-Rich Plasma for Partial-Thickness Rotator Cuff Tears

Purpose Treatment of partial-thickness rotator cuff tears (PTRCTs) remains controversial. Few studies have focused on the conservative and new measurements of small to medium PTRCTs. The use of sodium hyaluronate (SH) or platelet-rich plasma (PRP) as a method for rotator cuff repair requires further investigation. The aim of this study was to evaluate the combined use of SH and PRP in the treatment of small to medium PTRCTs. Study design Double-blinded randomized trial. Methods Individuals with PTRCTs detected by clinical examination and magnetic resonance imaging (MRI) were included in this study. The patients were randomly assigned to receive subacromial injections of normal saline (NS), SH, PRP or SH+PRP once a week for four weeks. The primary outcome measure was the Constant score, and the secondary outcomes included the American shoulder and elbow surgeons (ASES) and visual analog scale (VAS) scores. All of the clinical outcomes were assessed at pretreatment and 1, 3, 6, and 12 months posttreatment. MRI was used to evaluate the evolution of the cuff defect after 1 year. Results PRP group and SH+PRP group showed a significantly higher Constant score and ASES score after the treatments. There were significant differences between the SH+PRP group and SH or PRP group at 12 months in the Constant, VAS and ASES scores. MRI results showed that the tear size significantly decreased in both the PRP and SH+PRP groups, especially in the SH+PRP group. Conclusion Our study provided evidence of the efficacy of PRP injection in the healing of small to medium PTRCTs. Moreover, the combined injection of SH and PRP yielded a better clinical outcome than SH or PRP alone. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. *Contributed equally to this work Corresponding author: Pengfei Zhu, HanZheng Street 473, QiaoKou District, 430030, Wuhan, China, E-mail addresses: happyzhupengfei@163.com, Tel: 0086-13720162185. Competing interests None. Fundings Fundings were received from National Natural Science Foundation of Wuhan (Grant No. WX18Q21 to YC) and by the National Natural Science Foundation of Hubei (Grant No. 2018CFB568 to ZXS) and by the National Natural Science Foundation of China (Grant Nos. 81701716 to ZXS). The authors declare that the results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation, and the results of the study do not constitute endorsement by the American College of Sports Medicine. © 2018 American College of Sports Medicine

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