Assessing the efficacy of postoperative PRP injections following arthroscopic supraspinatus repair .
Questo studio è stato identificato come potenzialmente ad alto impatto.
La metrica High Impact di OE, guidata dall'AI, stima l'influenza che un articolo potrebbe avere integrando i segnali della rivista in cui è stato pubblicato e il contenuto scientifico dell'articolo stesso.
Sviluppato utilizzando un'elaborazione del linguaggio naturale all'avanguardia, il modello High Impact di OE prevede in modo più accurato la futura performance citazionale di uno studio rispetto al solo fattore di impatto della rivista.
Ciò consente di riconoscere prima le ricerche clinicamente significative e aiuta i lettori a concentrarsi sugli articoli che hanno maggiori probabilità di influenzare la pratica futura.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2018;6(9):13 Am J Sports Med. 2017 Nov;45(13):2965-297460 patients with an isolated, full-thickness supraspinatus tear were randomized to either receive two postoperative ultrasound-guided injections of platelet-rich plasma or to no adjunct postoperative intervention. Patients were evaluated over a mean of 3.5 years for MRI (Sugaya classification) and clinical outcomes (QuickDASH, Oxford Shoulder Score, and Constant Score). At a mean of 3.5 years, there were no significant differences in clinical scores between groups, with the exception of a greater score on the abduction subscale of the Constant score in the PRP group. MRI outcomes were similar between groups at final follow-up.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sì = 1
Incerto = 0,5
Non rilevante = 0
No = 0
La valutazione dei criteri di segnalazione valuta la trasparenza con cui gli autori riportano le caratteristiche metodologiche e sperimentali dello studio all'interno della pubblicazione. La valutazione è suddivisa in cinque categorie che vengono presentate di seguito.
4/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
4/5
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'Indice di Fragilità è uno strumento che aiuta l'interpretazione dei risultati significativi, fornendo una misura della forza di un risultato. L'Indice di Fragilità rappresenta il numero di eventi consecutivi che devono essere aggiunti a un risultato dicotomico per rendere il risultato non più significativo. Un numero piccolo rappresenta un risultato più debole, mentre un numero grande rappresenta un risultato più forte.
Perché questo studio era necessario ora?
Arthroscopic repair of a rotator cuff tear, though often clinically effective, suffers from a fairly high rate of retear. Platelet-rich plasma, applied either intraoperatively or as a postoperative injection, has been suggested to improve tendon healing and reduce the rate of retear. While a number of trials have reported short-term outcomes following the use of adjunct PRP therapy, few trials have provided medium-term follow-up.
Qual era la domanda di ricerca principale?
In arthroscopic supraspinatus repair, do postoperative injections of platelet-rich plasma at 7 and 14 days after surgery result in a significantly lower rate of tendon retear on MRI, over an average of 42 months of follow-up, when compared to patients who were not administered postoperative injections?
- At the mean follow-up time of 3.5 years, there were no differences in QuickDash, Oxford shoulder score, or the total Constant score between groups (p>0.05). A higher score on the strength subscale of the Constant score was observed in the PRP group (p=0.006).
- There were no differences in MRI scores or retear rates between groups, with 66.7% of the PRP group and 64.3% of the control patients rated as grade 1 using the Sugaya classification system.
Che cosa devo ricordare di più?
In arthroscopic supraspinatus repair, there were no significant differences in clinical or MRI outcomes between patients receiving or not receiving adjunct postoperative platelet-rich plasma injections, with the exception of a possible improvement in abduction strength.
Come influenzerà l'assistenza ai miei pazienti?
The use of platelet-rich plasma injections as an adjunct therapy following arthroscopic supraspinatus repair does not appear to provide considerable benefit in either MRI or clinical outcomes for patients at medium-term follow-up.
DISCLAIMER
Il contenuto di questa pagina è solo a scopo informativo e non intende sostituire la consulenza, la diagnosi o il trattamento medico professionale. Se ha bisogno di cure mediche, si rivolga sempre al suo medico o al pronto soccorso più vicino. Le opinioni, le convinzioni e i punti di vista espressi dalle persone sui contenuti presenti in questa pagina non riflettono le opinioni, le convinzioni e i punti di vista di OrthoEvidence.
0 di 4 articoli mensili GRATUITI sbloccati
