Wednesday, May 18, 2011

New Study shows PRP improves Rotator Cuff Repair Outcomes

Dr. Pietro Randelli and his colleagues just published a prospective randomized trial on the use of platelet rich plasma for rotator cuff repair surgery.  He showed a specific type of PRP (Increased platelets in combination with white blood cells) improved outcomes especially within the first 30 days.

Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up.
Authored By: Randelli PietroArrigoni PaoloRagone VincenzaAliprandi AlbertoCabitza Paolo
Department of Scienze Medico Chirurgiche, University of Milano, IRCCS Policlinico San Donato, Milano, Italy.
Pub Date: 06/2011Source/Vol: Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]/20
Hypothesis  Local application of autologous platelet rich plasma (PRP) improves tendon healing in patients undergoing arthroscopic rotator cuff repair.

Study Design  Prospective, randomized, controlled, double blind study; considering an alpha level of 5%, a power of 80%, 22 patients for group are needed.

Materials And Methods  Fifty-three patients who underwent shoulder arthroscopy for the repair of a complete rotator cuff tear were randomly divided into 2 groups, using a block randomization procedure. A treatment group (N = 26) consisted of those who received an intraoperative application of PRP in combination with an autologous thrombin component. A control group (N = 27) consisted of those who did not receive that treatment. Patients were evaluated with validated outcome scores. A magnetic resonance image (MRI) was performed in all cases at more than 1 year post-op. All patients had the same accelerated rehabilitation protocol.

Results  The 2 groups were homogeneous. The pain score in the treatment group was lower than the control group at 3, 7, 14, and 30 days after surgery (P < .05). On the Simple Shoulder Test (SST), University of California (UCLA), and Constant scores, strength in external rotation, as measured by a dynamometer, were significantly higher in the treatment group than the control group at 3 months after surgery (strength in external rotation [SER]: 3 ± 1.6 vs 2.1 ± 1.3 kg; SST: 8.9 ± 2.2 vs 7.1 ± 2.7; UCLA: 26.9 ± 3 vs 24.2 ± 4.9; Constant: 65 ± 9 vs 57.8 ± 11; P < .05). There was no difference between the 2 groups after 6, 12, and 24 months. The follow-up MRI showed no significant difference in the healing rate of the rotator cuff tear. In the subgroup of grade 1 and 2 tears, with less retraction, SER in the PRP group was significant higher at 3, 6, 12, and 24 months postoperative (P < .05).

Conclusion  The results of our study showed autologous PRP reduced pain in the first postoperative months. The long-term results of subgroups of grade 1 and 2 tears suggest that PRP positively affected cuff rotator healing.
Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
Publication Types: Journal Article
PubMed Link:

Wednesday, May 04, 2011

World Wide Regenerative Medicine Leader?

Regenerative Medicine is exploding worldwide.  There is a healthy debate emerging about who is in the lead.  Is it North America  (USA, Canada), Europe, South America, Australia or Asia?  Could Africa be the place of a monumental discovery discovery much like when Christiaan Barnard did the first heart transplant in Cape Town in 1967?

Countries and continents are taking vastly different approaches to stem cell treatments, genetic engineering and other forms of regenerative medicine.  Regulatory issues are especially different by country and changing rapidly.    It is also difficult to keep track of all the trials that are popping up everyday.

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