February 22, 2011

The Search for Rotator Cuff Tear Treatment

(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