8 settembre 2010
Grande risultato per la comunità scientifica italiana:
Pietro Randelli con il suo lavoro dal titolo: "Platelet Rich Plasma (PRP) in Arthroscopic Rotator Cuff Repair. A Prospective RCT Study,
2 Years Follow-up " vince il prestigioso Hiroaki Fukuda Best Paper Prize all'XI ICSES recentemente tenutosi ad Edimburgo.
Complimenti agli autori del lavoro che hanno così brillantemente tenuto alto il nome della comunità scientifica italiana e della Società Italiana di Chirurgia della Spalla e di Gomito.
Platelet Rich Plasma (PRP) in Arthroscopic Rotator Cuff Repair. A Prospective RCT Study,
2 Years Follow-up
Pietro Randelli1, Paolo Arrigoni1, Vincenza Ragone1, Paolo Cabitza1
1University of Milano, Dept. Scienze Medico Chirurgiche, IRCCS Policlinico San Donato, Milano, Italy
Hypothesis: Local application of autologous PRP improves tendon healing in patients undergone arthroscopic rotator cuff repair. Study design: Prospective, randomized, controlled, double blind study; Level of evidence, 1. Considering an alpha level of 5%, a power of 80%, 22 patients for group are needed.
Materials and Methods: Fifty-three patients who undergone a shoulder arthroscopy for the repair of complete rotator cuff tear, were randomly divided into two groups (block randomization procedure): a treatment group (N=26) who received an intra-operative application of PRP in combination with an autologous thrombin component and a control group (N=27). Patients were evaluated with Validated outcome score. An MRI was performed in all case at more than 1 year post-op. All patients had the same accelerated rehabilitation protocol.
Results: the two groups were omogeneous. Pain score in treatment group was lower than control group at 3, 7, 14 and 30 days after surgery (p< 0,05). Strenght in External Rotation (dynamometer), SST, UCLA and Constant scores in treatment group were significantly higher than control group at 3 months after surgery (SER: 3 ±1,6kg versus 2,1±1,3kg; SST: 8,9±2,2 versus 7,1±2,7; UCLA: 26,9±3 versus 24,2±4,9; Constant: 65±9 vs 57,8±11; p< 0,05). There was no difference between the two groups after 6, 12 and 24 months.The MRI follow-up showed no significant difference in the healing rate. In the subgroup of stage 1 and 2 tears, with less retraction and more prone to the effect of a biological therapy, SER in PRP group were significant higher at 3, 6, 12 and 24 months post-op. (p< 0,05).
Conclusions: The results of our study showed autologous PRP reduced pain in the first months post-op and promoted quicker healing. Long-term results of subgroups of stage 1 and 2 tears suggest PRP effectively affected cuff rotator healing.