Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management

Thangarajah, Tanujan; Lo, Ian K.Y.

doi:10.2147/orr.s348726

Cited by 13 publications

(14 citation statements)

References 86 publications

(131 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most often, the PTRCI concerns the supraspinatus tendon (SSP), which is a crucial factor in centring the humeral head during upper limb elevation [ 3 , 4 ]. In traumatic cases, the subscapularis and infraspinatus tendons are often affected by long head biceps instability [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Collagen and platelet-rich plasma in partial-thickness rotator cuff injuries. Friends or only indifferent neighbours? Randomised controlled trial

Godek¹,

Szczepanowska-Wołowiec

Golicki

2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Partial-thickness rotator cuff injuries (PTRCI) are the sum of degenerative, overload, and microtrauma processes. An external supply of collagen and platelet-rich plasma (PRP) could potentially counteract the deterioration of degenerative tendinopathy. This study aimed to compare the effectiveness of collagen with PRP, PRP alone, and collagen alone in the treatment of PTRCI. Methods Ninety patients with PTRCI were randomised and treated with ultrasound-guided injections into the shoulder bursa every consecutive week: Group A – collagen with PRP (n = 30), Group B – collagen alone (n = 30), and Group C – PRP alone (n = 30). Primary outcomes were pain intensity measured in control points on a numeric rating scale (NRS), QuickDash, and EQ-5D-5L questionnaires at the initial assessment (IA) and control assessments after 6 (T1), 12 (T2), and 24 (T3) weeks, respectively. Results No statistical differences were found between groups in primary outcomes, although there was a trend towards improvement in Groups A and C (opposite to Group B) between T2 and T3. The following parameters were also observed: rotator cuff discontinuity (n = 3, one case in each group) and rotator cuff regeneration (n = 22 in Group A, n = 20 in Group B, and n = 23 in Group C). Conclusions Combined therapy of collagen and PRP in PTRCI presents similar effectiveness to monotherapies with collagen or PRP. Trial registration The study was prospectively registered on the NCT Trial Center (identification number: NCT04492748) on 30.07.2020.

show abstract

Section: Introductionmentioning

confidence: 99%

Collagen and platelet-rich plasma in partial-thickness rotator cuff injuries. Friends or only indifferent neighbours? Randomised controlled trial

Godek¹,

Szczepanowska-Wołowiec

Golicki

2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Our updated systematic review and network meta-analysis is a further exploration of the therapeutic effects of three shoulder injections for rotator cuff tears. Fifteen of the 16 studies included in our review focused on patients with partial thickness rotator cuff tears, for whom nonoperative treatment is a viable first-line option with a low risk of fatty infiltration, tear progression and muscle atrophy [ 33 ]. Physiotherapy, medicine injections and activity modification are common options for nonoperative rotator cuff repair; however, if the underlying tears are not addressed, over 40% of partial thickness defects would progress to full-thickness tears within three years [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of three common shoulder injections for rotator cuff tears: a systematic review and network meta-analysis

Jiang

Zhang

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

Objective To compare the clinical effectiveness of three common shoulder injections mentioned in the guidelines [corticosteroid, sodium hyaluronate (SH) and platelet-rich plasma (PRP)] on rotator cuff tears. Material and methods The PubMed, Embase and Cochrane Library databases were systematically searched up to June 1, 2022, for randomized controlled trials (RCTs) and prospective studies on the three injection therapies for rotator cuff tears. The main results were pain relief and functional improvement at 1–5 months and over 6 months, pooled using a network meta-analysis and ranked by SUCRA score. The risk of bias of the included studies was assessed using the Cochrane Collaboration tool. Results Twelve RCTs and 4 prospective studies comprising a total of 1115 patients were included in the review. Three prospective studies were judged to be at high risk of selection bias and performance bias, and one was considered as having a high risk of detection bias. SH injection ranked first in the short term in pain relief (MD: − 2.80; 95%CI − 3.91, − 1.68) and functional improvement (MD:19.17; 95%CI 12.29, 26.05), while PRP injection obtained better results in the long term in both pain relief (MD: − 4.50; 95%CI − 4.97, − 4.03) and functional improvement (MD:11.11; 95%CI 0.53,21.68). Conclusions PRP injection has the potential to successfully treat rotator cuff tears as an alternative to corticosteroids in the long term, in terms of either therapeutic efficiency or adverse effects, followed by SH injection. More research is needed to make high-quality recommendations on treatment options for injection treatments of rotator cuff tears.

show abstract

“…However, the main biomechanical disadvantage of this method is that due to the excision of the intact articular‐side fibers, the normal tendon margin will be brought over and repaired to a relatively lateral bone bed, which will disrupt the normal length‐tension relationship of the musculotendinous unit 18 . Therefore, the optimal repair method for bursal‐side PTRCTs involving >50% of the thickness remains a controversial topic 19 …”

Section: Introductionmentioning

confidence: 99%

Functional and MRI Outcomes After In Situ Repair Versus Tear Completion Before Repair of Bursal‐Side Partial‐Thickness Rotator Cuff Tears

Zhuo

Pan

2023

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveThe optimal repair method for bursal‐side partial‐thickness rotator cuff tears (PTRCTs) involving >50% of the thickness remains a controversial topic. The study was aimed to compare the functional and magnetic resonance imaging (MRI) outcomes after in situ repair or tear completion before repair of bursal‐side PTRCTs.MethodsA retrospective clinical study was conducted involving 58 patients who underwent in situ repair or tear completion before repair of bursal‐side PTRCTs between January 2019 and December 2020. These patients were divided into two groups: the in situ repair group and the tear completion before repair group. Functional assessment consisted of active range of motion (ROM), visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Constant–Murley score. The percentages of patients in each group achieving the minimal clinical important difference (MCID) of the functional scores were determined. The healing status of the rotator cuff was assessed by postoperative MRI.ResultsThere were no statistically significant differences between the two groups in terms of demographic data. The mean follow‐up period was 14.53 ± 2.64 months in the in situ repair group and 15.40 ± 2.66 months in the tear completion before repair group. At the final follow‐up, the forward elevation, external rotation, and internal rotation improved significantly in both groups. The VAS, ASES score, and Constant–Murley score improved significantly in the in situ repair group (5.17 ± 2.00 points to 0.11 ± 0.41 points, p = 0.001; 44.04 ± 17.40 points to 95.47 ± 4.32 points, p = 0.001; 49.50 ± 14.38 points to 93.50 ± 3.49 points, p = 0.001) and in the tear completion before repair group (5.43 ± 3.32 points to 0.03 ± 0.18 points, p = 0.001; 41.50 ± 19.59 points to 95.94 ± 2.68 points, p = 0.001; 47.54 ± 17.13 points to 93.97 ± 2.61 points, p = 0.001). Postoperative MRI revealed that the re‐tear rate was 7.1% (2/28) in the in situ repair group and 3.3% (1/30) in the tear completion before repair group. No significant differences were observed in terms of the functional scores, the percentages of patients achieving the MCID of the functional scores, and the re‐tear rate between the two groups (p > 0.05).ConclusionsBoth in situ repair and tear completion before repair yielded satisfactory clinical outcomes for patients with bursal‐side PTRCTs. No significant differences were observed in the functional and MRI outcomes between the two groups.

show abstract

Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management

Cited by 13 publications

References 86 publications

Collagen and platelet-rich plasma in partial-thickness rotator cuff injuries. Friends or only indifferent neighbours? Randomised controlled trial

Collagen and platelet-rich plasma in partial-thickness rotator cuff injuries. Friends or only indifferent neighbours? Randomised controlled trial

Comparison of three common shoulder injections for rotator cuff tears: a systematic review and network meta-analysis

Functional and MRI Outcomes After In Situ Repair Versus Tear Completion Before Repair of Bursal‐Side Partial‐Thickness Rotator Cuff Tears

Contact Info

Product

Resources

About