Rotator Cuff Tears Clinical Trial
Official title:
Platelet Rich Plasma on Arthroscopic Repair of the Complete Rotator Cuff Lesions: a Prospective and Randomized Study
Repair of the rotator cuff has high rates of re-rupture (20-54%), despite good clinical results. Several ways to improve the healing tendon-bone are currently studied, among them the most used is the use of growth factors. The platelet-rich plasma is a source of several growth factors, and is already used in various orthopedic procedures. The aim of this study is to evaluate the effectiveness of platelet-rich plasma in improve tendon-bone healing in arthroscopic rotator cuff repairs.
Rotator cuff repair(RCR) is a procedure widely performed in the shoulder surgery, given the
high prevalence of this type of injury in the population. Regardless of the approach
employed, the procedure consists of the rehabilitation of the rotator cuff to his bed.
Despite the clinical results are highly satisfactory (success rate around 85%), studies
using ultrasound and magnetic resonance imaging (MRI) showed a rate of re-rupture after
surgery 20 to 54%. These levels of re-injury suggest a sub-optimal healing in the
bone-tendon interface.
Attempts to improve the healing in place of the RMR has been extensively studied in the
orthopedic literature. One is the use of growth factors (GF), cytokines play an important
role in chemotaxis, cell proliferation and differentiation, as well as the synthesis of
extracellular matrix, and that theoretically could have beneficial role in tissue repair.
The Platelet-Rich Plasma (PRP) is one of the most studied sources of GF. It is easy to
prepare and non-immunogenic (is done with the patient's own blood), and has the further
advantage of the presence of several FC (including PDGF, bFGF, TGF-B, VEGF, EGF, CTGF and
IGF). This fact is important because the disease have different effects on different
receivers during the various stages of healing.
The use of PRP in bone healing has been evaluated in several studies with conflicting
results. There are preclinical studies demonstrating the beneficial effect of PRP on tendon
and ligament repair. However, there is no published papers showing the effectiveness of the
use of PRP on tendon-bone interface.
The aim of this study is to evaluate the effectiveness of PRP in enhancing the healing
tendon-bone repair after injury of RC.
Will be operated patients with complete injury (full thickness) of the rotator cuff, divided
into two groups randomly. The use of PRP or not will be decided by sealed envelopes, with 20
individuals in each group. The subjects will be assessed pre and postoperatively according
to the criteria for the Constant and UCLA and with the help of MRI, being unknown to the
evaluators to which group the patient belongs.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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