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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2018

Open Access 01-12-2018 | Research article

Effects of bone marrow aspirate concentrate and platelet-rich plasma on patients with partial tear of the rotator cuff tendon

Authors: Sang Jun Kim, Eun Kyung Kim, Sun Jeong Kim, Da Hyun Song

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2018

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Abstract

Background

We compared the clinical course of rotator cuff tears between rotator cuff exercise and bone marrow aspirate concentration (BMAC)-platelet rich plasma (PRP) injection to identify the therapeutic effects of BMAC-PRP on partial tear of the rotator cuff tendon.

Methods

Twenty-four patients with partial tear of the rotator cuff tendon participated in this study. Twelve patients underwent extraction of BMACs and PRP and received the injection of BMAC-PRP at the tear site under ultrasound guidance. Twelve patients in the control group were asked to perform the rotator cuff exercise for 3 months. Visual analog scale (VAS) and manual muscle test (MMT) scores of the supraspinatus muscle were measured, and the American Shoulder and Elbow Surgeons (ASES) score was recorded before, 3 weeks, and 3 months after injection. Tear size was measured by the greatest longitudinal tear length.

Results

The change in the VAS differed between groups at 3 months (P = 0.039) but not at 3 weeks (P = 0.147). The ASES scores in the BMAC-PRP group changed from 39.4 ± 13.0 to 54.5 ± 11.5 at 3 weeks and 74.1 ± 8.5 at 3 months while those in the control group changed from 45.9 ± 12.4 to 56.3 ± 12.3 at 3 weeks (P = 0.712) and 62.2 ± 12.2 at 3 months (P = 0.011). The tear size decreased at 3 weeks or 3 months after the BMAC-PRP injection but was not significantly different from that in the control group.

Conclusions

BMAC-PRP improved pain and shoulder function in patients with partial tear of the rotator cuff tendon.

Trial registration

The patients were registered in the institutional board registry of Samsung Medical Center (registry number 2014-07-173).
Appendix
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Literature
1.
Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H, Kobayashi T. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elb Surg. 2010;19:116–20.CrossRef
2.
Hashimoto T, Nobuhara K, Hamada T. Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clin Orthop Relat Res. 2003;(415):111–20.
3.
Longo UG, Berton A, Papapietro N, Maffulli N, Denaro V. Epidemiology, genetics and biological factors of rotator cuff tears. Med Sport Sci. 2012;57:1–9.PubMed
4.
Baumgarten KM, Gerlach D, Galatz LM, Teefey SA, Middleton WD, Ditsios K, Yamaguchi K. Cigarette smoking increases the risk for rotator cuff tears. Clin Orthop Relat Res. 2010;468:1534–41.CrossRefPubMed
5.
Longo UG, Franceschi F, Berton A, Maffulli N, Droena V. Conservative treatment and rotator cuff tear progression. Med Sport Sci. 2012;57:90–9.CrossRefPubMed
6.
Kim YS, Kim SE, Bae SH, Lee HJ, Jee WH, Park CK. Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI. Knee Surg Sports Traumatol Arthrosc. 2017;25:2073–80.
7.
Moosmayer S, Gartner AV, Tariq R. The natural course of nonoperatively treated rotator cuff tears: an 8.8-year follow-up of tear anatomy and clinical outcome in 49 patients. J Shoulder Elb Surg. 2017;26:627–34.CrossRef
8.
Hein J, Reilly JM, Chae J, Maerz T, Anderson K. Retear rates after arthroscopic single-row, double-row, and suture bridge rotator cuff repair at a minimum of 1 year of imaging follow-up: a systematic review. Arthroscopy. 2015;31:2274–81.CrossRefPubMed
9.
Murray IR, LaPrade RF, Musahl V, Geeslin AG, Zlotnicki JP, Mann BJ, Petrigliano FA. Biologic treatments for sports injuries II think tank-current concepts, future research, and barriers to advancement, part 2: rotator cuff. Orthop J Sports Med. 2016;4:2325967116636586.PubMedPubMedCentral
10.
Gumucio JP, Flood MD, Roche SM, Sugg KB, Momoh AO, Kosnik PE, Bedi A, Mendias CL. Stromal vascular stem cell treatment decreases muscle fibrosis following chronic rotator cuff tear. Int Orthop. 2016;40:759–64.CrossRefPubMed
11.
Park GY, Kwon DR, Lee SC. Regeneration of full-thickness rotator cuff tendon tear after ultrasound-guided injection with umbilical cord blood-derived Mesenchymal stem cells in a rabbit model. Stem Cells Transl Med. 2015;4:1344–51.CrossRefPubMedPubMedCentral
12.
13.
Zhou Y, Zhang J, Wu H, Hogan MV, Wang JH. The differential effects of leukocyte-containing and pure platelet-rich plasma (PRP) on tendon stem/progenitor cells—implications of PRP application for the clinical treatment of tendon injuries. Stem Cell Res Ther. 2015;6:173.CrossRefPubMedPubMedCentral
14.
Kim SJ, Song DH, Park JW, Park S, Kim SJ. Effect of bone marrow aspirate concentrate-platelet-rich plasma on tendon-derived stem cells and rotator cuff tendon tear. Cell Transplant. 2017;26:867–78.CrossRefPubMedPubMedCentral
15.
Hasan S, Weinberg M, Khatib O, Jazrawi L, Strauss EJ. The effect of platelet-rich fibrin matrix on rotator cuff healing in a rat model. Int J Sports Med. 2016;37:36–42.PubMed
16.
Yuksel S, Gulec MA, Gultekin MZ, Adanir O, Caglar A, Beytemur O, Onur Kucukyildirim B, Avci A, Subasi C, Inci C, Karaoz E. Comparison of the early period effects of bone marrow-derived mesenchymal stem cells and platelet-rich plasma on the Achilles tendon ruptures in rats. Connect Tissue Res. 2016;57:360–73.CrossRefPubMed
17.
Greenspoon JA, Moulton SG, Millett PJ, Petri M. The role of platelet rich plasma (PRP) and other biologics for rotator cuff repair. Open Orthop J. 2016;10:309–14.CrossRefPubMedPubMedCentral
18.
D'Ambrosi R, Palumbo F, Paronzini A, Ragone V, Facchini RM. Platelet-rich plasma supplementation in arthroscopic repair of full-thickness rotator cuff tears: a randomized clinical trial. Musculoskelet Surg. 2016;100:25–32.CrossRefPubMed
19.
Gulotta LV, Kovacevic D, Packer JD, Deng XH, Rodeo SA. Bone marrow-derived mesenchymal stem cells transduced with scleraxis improve rotator cuff healing in a rat model. Am J Sports Med. 2011;39:1282–9.CrossRefPubMed
20.
Kim YS, Lee HJ, Ok JH, Park JS, Kim DW. Survivorship of implanted bone marrow-derived mesenchymal stem cells in acute rotator cuff tear. J Shoulder Elb Surg. 2013;22:1037–45.CrossRef
21.
Lian Z, Yin X, Li H, Jia L, He X, Yan Y, Liu N, Wan K, Li X, Lin S. Synergistic effect of bone marrow-derived mesenchymal stem cells and platelet-rich plasma in streptozotocin-induced diabetic rats. Ann Dermatol. 2014;26:1–10.CrossRefPubMedPubMedCentral
22.
Betsch M, Schneppendahl J, Thuns S, Herten M, Sager M, Jungbluth P, Hakimi M, Wild M. Bone marrow aspiration concentrate and platelet rich plasma for osteochondral repair in a porcine osteochondral defect model. PLoS One. 2013;8:e71602.CrossRefPubMedPubMedCentral
23.
Zhao T, Yan W, Xu K, Qi Y, Dai X, Shi Z. Combined treatment with platelet-rich plasma and brain-derived neurotrophic factor-overexpressing bone marrow stromal cells supports axonal remyelination in a rat spinal cord hemi-section model. Cytotherapy. 2013;15:792–804.CrossRefPubMed
24.
von Wehren L, Blanke F, Todorov A, Heisterbach P, Sailer J, Majewski M. The effect of subacromial injections of autologous conditioned plasma versus cortisone for the treatment of symptomatic partial rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2016;24:3787–92.CrossRefPubMed
25.
Aitkens S, Lord J, Bernauer E, Fowler WM Jr, Lieberman JS, Berck P. Relationship of manual muscle testing to objective strength measurements. Muscle Nerve. 1989;12:173–7.CrossRefPubMed
26.
Angst F, Schwyzer HK, Aeschlimann A, Simmen BR, Goldhahn J. Measures of adult shoulder function: disabilities of the arm, shoulder, and hand questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), simple shoulder test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S174–88.CrossRef
27.
Okoroha KR, Mehran N, Duncan J, Washington T, Spiering T, Bey MJ, Van Holsbeeck M, Moutzouros V. Characterization of rotator cuff tears: ultrasound versus magnetic resonance imaging. Orthopedics. 2017;40:e124–e130.
28.
Cox E, Martin BC, Van Staa T, Garbe E, Siebert U, Johnson ML. Good research practices for comparative effectiveness research: approaches to mitigate bias and confounding in the design of nonrandomized studies of treatment effects using secondary data sources: the International Society for Pharmacoeconomics and Outcomes Research Good Research Practices for Retrospective Database Analysis Task Force Report—part II. Value Health. 2009;12:1053–61.CrossRefPubMed
29.
Shams A, El-Sayed M, Gamal O, Ewes W. Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears. Eur J Orthop Surg Traumatol. 2016;26:837–42.CrossRefPubMed
30.
Scarpone M, Rabago D, Snell E, Demeo P, Ruppert K, Pritchard P, Arbogast G, Wilson JJ, Balzano JF. Effectiveness of platelet-rich plasma injection for rotator cuff tendinopathy: a prospective open-label study. Glob Adv Health Med. 2013;2:26–31.CrossRefPubMedPubMedCentral
31.
Geburek F, Gaus M, van Schie HT, Rohn K, Stadler PM. Effect of intralesional platelet-rich plasma (PRP) treatment on clinical and ultrasonographic parameters in equine naturally occurring superficial digital flexor tendinopathies - a randomized prospective controlled clinical trial. BMC Vet Res. 2016;12:191.CrossRefPubMedPubMedCentral
32.
Andia I, Rubio-Azpeitia E, Maffulli N. Platelet-rich plasma modulates the secretion of inflammatory/angiogenic proteins by inflamed tenocytes. Clin Orthop Relat Res. 2015;473:1624–34.CrossRefPubMedPubMedCentral
33.
Tong S, Liu J, Zhang C. Platelet-rich plasma inhibits inflammatory factors and represses rheumatoid fibroblast-like synoviocytes in rheumatoid arthritis. Clin Exp Med. 2017;17:441–9.
34.
Desando G, Bartolotti I, Vannini F, Cavallo C, Castagnini F, Buda R, Giannini S, Mosca M, Mariani E, Grigolo B. Repair potential of matrix-induced bone marrow aspirate concentrate and matrix-induced autologous chondrocyte implantation for talar osteochondral repair: patterns of some catabolic, inflammatory, and pain mediators. Cartilage. 2017;8:50–60.CrossRefPubMed
35.
Martin JR, Houdek MT, Sierra RJ. Use of concentrated bone marrow aspirate and platelet rich plasma during minimally invasive decompression of the femoral head in the treatment of osteonecrosis. Croat Med J. 2013;54:219–24.CrossRefPubMedPubMedCentral
36.
Cai YZ, Zhang C, Lin XJ. Efficacy of platelet-rich plasma in arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis. J Shoulder Elb Surg. 2015;24:1852–9.CrossRef
37.
Zhang Z, Wang Y, Sun J. The effect of platelet-rich plasma on arthroscopic double-row rotator cuff repair: a clinical study with 12-month follow-up. Acta Orthop Traumatol Turc. 2016;50:191–7.CrossRefPubMed
38.
Pandey V, Bandi A, Madi S, Agarwal L, Acharya KK, Maddukuri S, Sambhaji C, Willems WJ. Does application of moderately concentrated platelet-rich plasma improve clinical and structural outcome after arthroscopic repair of medium-sized to large rotator cuff tear? A randomized controlled trial. J Shoulder Elb Surg. 2016;25:1312–22.CrossRef
39.
Stein BE, Stroh DA, Schon LC. Outcomes of acute Achilles tendon rupture repair with bone marrow aspirate concentrate augmentation. Int Orthop. 2015;39:901–5.CrossRefPubMed
40.
Kim HJ, Nam HW, Hur CY, Park M, Yang HS, Kim BS, Park JH. The effect of platelet rich plasma from bone marrow aspirate with added bone morphogenetic protein-2 on the Achilles tendon-bone junction in rabbits. Clin Orthop Surg. 2011;3:325–31.CrossRefPubMedPubMedCentral
41.
Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am. 2005;87:187–202.PubMed
42.
Castagna A, Borroni M, Garofalo R, Rose GD, Cesari E, Padua R, Conti M, Gumina S. Deep partial rotator cuff tear: transtendon repair or tear completion and repair? A randomized clinical trial. Knee Surg Sports Traumatol Arthrosc. 2015;23:460–3.CrossRefPubMed
43.
Boorman RS, More KD, Hollinshead RM, Wiley JP, Brett K, Mohtadi NG, Nelson AA, Lo IK, Bryant D. The rotator cuff quality-of-life index predicts the outcome of nonoperative treatment of patients with a chronic rotator cuff tear. J Bone Joint Surg Am. 2014;96:1883–8.CrossRefPubMed
Metadata
Title
Effects of bone marrow aspirate concentrate and platelet-rich plasma on patients with partial tear of the rotator cuff tendon
Authors
Sang Jun Kim
Eun Kyung Kim
Sun Jeong Kim
Da Hyun Song
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2018
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-017-0693-x

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