Plasma rico em plaquetas e corticoide no tratamento da síndrome de impacto do manguito rotador: Ensaio Clínico randomizado

Abstract

Objective This research aims to study the effectiveness of platelet-rich plasma (PRP) in the treatment of patients with rotator cuff impingement syndrome compared with the treatment with subacromial injection of corticosteroids. Methods This is a double-blind, randomized, comparative clinical trial. The patients were clinically evaluated with the use of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure, University of California Los Angeles (UCLA) shoulder rating scale and Constant-Murley shoulder outcome score (CMS) on the day of application, and then again after 1, 3 and 6 months. Results No statistically significant differences were found ( p < 0.05) when comparing the results of the DASH outcome measure, UCLA shoulder rating scale and CMS of the two groups at baseline and after 1, 3, and 6 months of treatment with subacromial injection. After the treatment, both groups showed a significant improvement in the DASH and UCLA scores ( p < 0.05) when compared with the baseline. However, the CMS at 6 months after treatment with steroids was lower than the baseline. Concusions These findings suggest that PRP is a safe treatment and can be a useful tool in the therapeutic arsenal against of the rotator cuff diseases, for there was no significant difference between the subacromial use of PRP and corticosteroids.

Platelet‐rich plasma versus corticosteroid injections in the management of patients with rotator cuff disease: A systematic review and meta‐analysis

“…Similarly, at the intermediate point, no difference in the change from base‐line was observed between the treatments (MD = −7.73, 95% CI: −18.68, 3.23; p = 0.17; I 2 = 87%. 25 , 28 , 33 , 35 The two groups were comparable at the medium‐term point (MD = −2.65, 95% CI: −11.70, 6.40; p = 0.57; I 2 = 91% 12 , 25 , 28 , 33 , 35 ).…”

“…At the intermediate‐term follow‐up, there exists a difference with a greater change in the PRP group in comparison to the CS group with a mean DASH score of −25.56 and −24.31, respectively (MD = 3.41, 95% CI: 0.67, 6.15; p = 0.01; I 2 = 0% 25 , 26 , 28 , 30 ). During medium‐term follow‐up, the mean change from baseline was comparable between the two groups with no difference (MD = 0.95, 95% CI: −4.88, 6.79; p = 0.75; I 2 = 80% 25 , 28 ).…”

“…CMS score was reported in five studies 12 , 25 , 28 , 33 , 35 (Figure 4 ). At the short‐term follow‐up, no difference in the change from base‐line was observed between the two groups (MD = 3.18, 95% CI: −5.78, 12.14; p = 0.49; I 2 = 91%).…”

“…DASH score was reported in four studies 25 , 26 , 28 , 30 (Figure 5 ). At the short‐term follow‐up, there exists a difference between the two cohorts such that the change from baseline was higher in the CS group in comparison to the PRP group with a mean change of −16.71 and −10.92, respectively (MD = −5.08, 95% CI: −8.00, −2.15; p = 0.0007; I 2 = 0% 25 , 26 , 28 , 30 ).…”

“…DASH score was reported in four studies 25 , 26 , 28 , 30 (Figure 5 ). At the short‐term follow‐up, there exists a difference between the two cohorts such that the change from baseline was higher in the CS group in comparison to the PRP group with a mean change of −16.71 and −10.92, respectively (MD = −5.08, 95% CI: −8.00, −2.15; p = 0.0007; I 2 = 0% 25 , 26 , 28 , 30 ). At the intermediate‐term follow‐up, there exists a difference with a greater change in the PRP group in comparison to the CS group with a mean DASH score of −25.56 and −24.31, respectively (MD = 3.41, 95% CI: 0.67, 6.15; p = 0.01; I 2 = 0% 25 , 26 , 28 , 30 ).…”