Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Relative Energy Deficiency in Sport (REDs) and knee injuries: current concepts for female athletes","authors":"","doi":"10.1016/j.jisako.2024.05.012","DOIUrl":"10.1016/j.jisako.2024.05.012","url":null,"abstract":"<div><p>In athletes, a mismatch between caloric intake and energy expended in exercise can eventually lead to Relative Energy Deficiency in Sport (REDs), where the athlete suffers from physiological derangements and decreased sport performance. The prevalence of REDs is higher in females than males. Females are already at a higher risk of knee injuries, which has been attributed to a multitude of factors such as hormonal influences, differences in musculoskeletal anatomy and neuromuscular control compared to males. The literature demonstrates an even higher risk of knee injuries in female athletes with symptoms of REDs. We propose the various factors that influence this risk. A reduction in anabolic hormones can affect muscle development and tendon repair. A relationship between poor neuromuscular control and knee injury has been established, and this can be further worsened in patients with menstrual dysfunction. Chronic deficiency in nutrients such as collagen and vitamin D can result in poorer recovery from microtrauma in tendons and ligaments. All these factors may contribute to increasing the risk of knee injuries, which may include anterior cruciate ligament tears, patella tendinopathy and patellofemoral pain syndrome. This review aims to educate sports clinicians to have a high index of suspicion when treating knee injuries in females; to screen and then manage for REDs if present, for holistic patient care.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000993/pdfft?md5=a697a3fa1b31da2b7d50146daa3b7185&pid=1-s2.0-S2059775424000993-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-resolution magnetic resonance imaging can predict osteoarthritic progression after medial meniscus posterior root injury: randomized in vivo experimental study in a rabbit model","authors":"","doi":"10.1016/j.jisako.2024.03.015","DOIUrl":"10.1016/j.jisako.2024.03.015","url":null,"abstract":"<div><h3>Importance</h3><p>The field of meniscal root preservation has undergone significant advancement over the past decades; however, the challenge remains to fully understand whether meniscal root repair can ultimately arrest or delay osteoarthritic changes.</p></div><div><h3>Objective</h3><p>To assess longitudinal changes in articular cartilage, subchondral bone, and progression to meniscal extrusion (ME) using high-resolution magnetic resonance imaging (MRI).</p></div><div><h3>Methods</h3><p>Medial meniscus posterior root tear was surgically induced in 39 New Zealand white rabbits. Animals were randomly assigned into three experimental groups: partial meniscectomy after root tear (PM, n ​= ​13); root tear left in situ (CT, n ​= ​13); and transtibial root repair (RR, n ​= ​13). Contralateral limbs were used as healthy controls. High resolution 4.7 Tesla MRI of the knee joint was performed at baseline, after 2-, and 4-months of post-surgery. Cartilage thickness was calculated in medial and lateral compartments. In addition, the evaluation of ME, subchondral bone edema and healing potential after root repair were assessed too.</p></div><div><h3>Results</h3><p>Progressive cartilage thinning, ME, and subchondral bone edema were evident in all 3 study groups after 4-months of follow-up. The mean cartilage thickness in the PM group was 0.53 ​mm (±0.050), 0.57 ​mm (±0.05) in the CT group, and 0.60 ​mm (±0.08) in the RR group. The PM group exhibited significantly higher cartilage loss when compared to the CT and RR groups (p ​&lt; ​0.001). Moreover, progressive ME and subchondral bone edema were associated with a more severe cartilage loss at the final follow-up.</p></div><div><h3>Conclusion</h3><p>Meniscal root repair did not halt but rather reduced the progression of osteoarthritis (OA). Degenerative changes worsened at a rapid rate in the PM group compared to the RR and CT groups. Early cartilage swelling, persistent subchondral edema, and progressive ME predicted a more severe progression to knee OA in the CT and RR groups.</p></div><div><h3>Level of evidence</h3><p>II.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000695/pdfft?md5=62db8eaed8296fd339d55296f3849308&pid=1-s2.0-S2059775424000695-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140836238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined tibial deflexion osteotomy and anterior cruciate ligament reconstruction improves knee function and stability: A systematic review","authors":"","doi":"10.1016/j.jisako.2024.06.010","DOIUrl":"10.1016/j.jisako.2024.06.010","url":null,"abstract":"<div><h3>Importance</h3><p>Patients with excessive posterior tibial slope (PTS) may have higher risks of anterior cruciate ligament (ACL) reconstruction (ACL-R) failure, and clinical outcomes after revision of ACL-R procedures are typically poor.</p></div><div><h3>Objective</h3><p>This study aimed to perform a systematic review of the literature summarizing the clinical and radiological outcomes of the surgical treatment of ACL insufficiency in the setting of excessive PTS using a tibial deflexion osteotomy combined with ACL-R.</p></div><div><h3>Evidence review</h3><p>A systematic review of the literature was performed using PubMed, Cochrane Library, and OVID Medline databases from 1990 to present. Inclusion criteria were studies of outcomes of isolated tibial deflexion osteotomies performed with primary or revision ACL-R in the English language. Data extracted included study demographic information, type of tibial deflexion osteotomy and concomitant procedures, radiological outcomes, patient-reported outcome scores, and postoperative complications.</p></div><div><h3>Findings</h3><p>Six studies, with 133 knees were identified. All included studies were retrospective case series, with a weighted mean follow-up of 3.39 years. In 106 of 133 (79.7%) knees, tibial deflexion osteotomy was performed concomitantly with an ACL-R, whereas in 27 of 133 (20.3%) knees, the procedures were staged. 22, 45, and 66 of 133 knees (16.5%, 33.8%, and 49.6%) underwent primary, first revision, and second or greater revision ACL-R, respectively. Three of 133 (2.25%) knees demonstrated recurrent ACL graft failure at the final follow-up. On average, PTS decreased from 15.2° preoperatively to 7.1° postoperatively. The mean International Knee Documentation Committee, Lysholm, and Tegner scores increased from 42.5, 46.4, and 4.2 preoperatively to 71.8, 89.0, and 6.7 postoperatively.</p></div><div><h3>Conclusions</h3><p>The results of this review suggest that combined ACL-R and tibial deflexion osteotomy may be effective in decreasing PTS and improving knee function and stability.</p></div><div><h3>Study design</h3><p>Systematic Review; Level of evidence 4.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001275/pdfft?md5=2db3e624d97bddb08104620faf566dda&pid=1-s2.0-S2059775424001275-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patellofemoral arthroplasty: Editorial","authors":"","doi":"10.1016/j.jisako.2024.06.011","DOIUrl":"10.1016/j.jisako.2024.06.011","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424001287/pdfft?md5=7aa019b98fdb3a70c9db8bda3222fa01&pid=1-s2.0-S2059775424001287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The “Golden Age” of quadriceps tendon grafts for the anterior cruciate ligament: a bibliometric analysis","authors":"","doi":"10.1016/j.jisako.2024.03.007","DOIUrl":"10.1016/j.jisako.2024.03.007","url":null,"abstract":"<div><h3>Importance</h3><p>Bibliometric research is a statistical analysis of publications to measure the scientific output in a specific field in order to highlight medical developments or knowledge gaps and to direct future scientific research. The quantity of orthopedic papers on the internet is astounding and is steadily growing as a result of recent advancements in technology and medicine. This is why choosing the right information is essential.</p></div><div><h3>Aim</h3><p>The purpose of this study was to analyze the current literature for trends in publications regarding quadriceps tendon (QT) grafting of the anterior cruciate ligament (ACL).</p></div><div><h3>Evidence review</h3><p>PubMed was searched on August 28, 2023. References were collected from PubMed, and trends were analyzed using this information. This search retrieved 405 articles regarding human and animal studies. We analyzed the top 10 authors and journals in terms of publication numbers, citation numbers, and citations per year. The PubMed-by-year feature was used to compare the number of publications regarding ACL reconstruction by quadriceps grafting with all publications in PubMed.</p></div><div><h3>Findings</h3><p>The number of yearly publications averaged 10 or less up to 2018, starting from 1982 when the first paper on the QT was published. However, the number of publications increased from 2018. While the total number of publications on this topic was 405, 260 were published from 2018 alone. The number of citations was 8262 in total overall years. It is expected that the last five years' publications, especially those for the last year, will be low in number, as it takes time for citations to accrue. The journal <em>Arthroscopy</em> published the most articles on this topic, with 57 papers and 1884 citations, followed by the <em>American Journal of Sports Medicine</em>, with 39 articles and 1576 citations. The top three journals on this topic were <em>Arthroscopy</em>, <em>A</em><em>merican</em> <em>J</em><em>ournal</em> <em>of</em> <em>S</em><em>ports</em> <em>M</em><em>edicine</em>, and <em>K</em><em>nee</em> <em>S</em><em>urgery</em>, <em>S</em><em>ports</em> <em>T</em><em>raumatology</em>, <em>A</em><em>rthroscopy</em>. The most published author was Musahl V (with 24 articles), and the most cited author was Xerogeanes JW (with 570 citations).</p></div><div><h3>Conclusions and relevance</h3><p>Global trend analysis suggests that research on anterior cruciate ligament reconstruction with the quadriceps has significantly increased in the last 5 years and that the number of papers on this topic is increasing steadily. We found that the publications and citations are exhibiting a rising trend, <em>Arthroscopy</em> is the most impactful journal, and Musahl V is the most impactful author on the topic. Xerogeanes JW is the author with the most citations on the topic. The promising clinical results of anterior cruciate ligament reconstruction with the QT have attracted th","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S205977542400052X/pdfft?md5=8bccebed1d2320f7d0225c7947785311&pid=1-s2.0-S205977542400052X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic proximal radioulnar synostosis: Current concepts on the clinical presentations, classifications, and open surgical approaches","authors":"","doi":"10.1016/j.jisako.2024.04.015","DOIUrl":"10.1016/j.jisako.2024.04.015","url":null,"abstract":"<div><p>In the forearm, posttraumatic heterotopic ossification usually forms as a proximal radioulnar synostosis. It can occur after soft tissue injury involving the interosseous membrane or after surgery involving the radio and ulna, such as distal biceps tendon repair. It can also be induced by radial head dislocation or fracture. Screening radiography can be used to select the appropriate time for excision. The synostosis can be resected when the ectopic bone margin and trabeculation appear mature on radiographs. An interval of 6–12 months from the injury is generally recommended based on ectopic bone maturity. Selection of the surgical approach depends on site, extension (elbow joint or proximal radioulnar joint), severity of the initial articular surface, and periarticular tissue injury. The posterolateral approach is indicated for synostoses: at or distal to the bicipital tuberosity, at the level of the radial head, and proximal radioulnar joint. The posterior global approach is recommended when the forearm synostosis is associated with complete bony ankylosis of the elbow involving the distal aspect of the humerus. After surgical resection of a proximal radioulnar synostosis, the exposed bone surfaces can be covered with interposition material to minimize recurrence.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000853/pdfft?md5=4f6f7d60b5e27239395dc91cc2ab14cf&pid=1-s2.0-S2059775424000853-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated patellofemoral arthroplasty-surgical technique and tips: current concepts","authors":"","doi":"10.1016/j.jisako.2023.11.009","DOIUrl":"10.1016/j.jisako.2023.11.009","url":null,"abstract":"<div><p>Successful patellofemoral arthroplasty (PFA) requires appropriate patient selection, correct implant positioning and attention to surgical technique. Whilst the original concept and rationale offered an attractive surgical option for patients with isolated patellofemoral arthritis, early results were disappointing and consequently many surgeons became reluctant to offer it. With newer-generation designs, outcomes have been more promising. However, attention to surgical technique remains an integral component to a successful outcome, with results being unforgiving when surgical errors are made. This paper explores the key components of the surgical technique in PFA, including implant design, patient selection and tips to avoid common mistakes.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775423005990/pdfft?md5=5a233657a702550b1e24e86f5b9ab444&pid=1-s2.0-S2059775423005990-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated patellofemoral osteoarthritis is not a contraindication for unicompartmental knee replacement. Report of one hundred ten prostheses with an average 6-year follow-up","authors":"","doi":"10.1016/j.jisako.2024.04.003","DOIUrl":"10.1016/j.jisako.2024.04.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Associated patellofemoral joint osteoarthritis (APFJ-OA) has typically been considered a contraindication for unicompartmental knee arthroplasty (UKA) in the treatment of femorotibial joint osteoarthritis. However, this contraindication is being challenged. The aim of this study was to assess clinical and functional outcomes, complications, and implant survival in medial or lateral UKA, regardless of clinical symptoms or radiographic signs of APFJ-OA.</p></div><div><h3>Methods</h3><p>This retrospective, comparative study included patients treated with medial or lateral UKA regardless of preoperative symptoms or signs of APFJ-OA, with a minimum 2-year follow-up. Intraoperatively, knees were subdivided based on APFJ-OA grade, according to the Outerbridge classification. Clinical and functional outcomes were analyzed using the 2011 Knee Society Score (KSS) at the last follow-up control. APFJ-OA was treated systematically, in a tailored, stepwise fashion according to its severity. Complications and implant survival rates were evaluated. Two-sided paired T-test, ANOVA, and Kruskal–Wallis tests were used with a significance level of 5%.</p></div><div><h3>Results</h3><p>Finally, 110 UKAs were assessed 81 (73.6%) medial and 29 (26.4%) laterals. The average follow-up was 6 years (2–19.5). According to Outerbridge, 22 knees (20%) were in grade 2, 59 (53.6%) were in grade 3, and 29 (26.4%) were in grade 4. All three groups showed a statistically significant increase in KSS scores and range of motion. There were no significant differences in clinical KSS improvement and flexion contracture between Outerbridge groups (average 35.7 and −4.9, respectively). Group 3 showed statistically significant improvement in functional KSS when compared to group 2 (68.8 vs 61.2). In maximum flexion, groups 3 and 4 did significantly better than group 2 (20° vs 15°). Three prostheses (2.7%) needed revision after 7, 8.6, and 12 years due to aseptic tibial loosening. Implant survival was 100% at 5 (64 of 64), 97% at 7 (30 of 31), 93% at 9 (14 of 15), and 89% at 12 years, respectively (8 of 9).</p></div><div><h3>Conclusion</h3><p>Clinical and functional results, complications, and survival of medial or lateral UKA were not negatively affected by APFJ-OA assessed intraoperatively using the Outerbridge classification after an average follow-up of 6 years. We consider that APFJ-OA is not a contraindication for UKA when treated systematically according to its severity.</p></div><div><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000737/pdfft?md5=6668ceee67be8b6a6a6b90c58a4bafec&pid=1-s2.0-S2059775424000737-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140836582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher contact pressure of the lateral tibiofemoral joint in lateral extra-articular tenodesis with tensioned graft in external rotation than in neutral rotation: A biomechanical study","authors":"","doi":"10.1016/j.jisako.2024.04.009","DOIUrl":"10.1016/j.jisako.2024.04.009","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the mean contact pressure, peak contact pressure, and mean contact area of the lateral tibiofemoral joint in lateral extra-articular tenodesis (LET) with tension on the graft in tibial neutral and external rotation.</p></div><div><h3>Methods</h3><p>A total of eight Thiel-embalmed cadaveric knees were prepared and divided into two groups (4 knees in each group): the LET-NR group (lateral extra-articular tenodesis tension in neutral rotation) and (2) the LET-ER group (lateral extra-articular tenodesis tension in external rotation). Each knee was prepared according to the corresponding technique. A hydraulic testing system (E10000, Instron) simulates an axial load of 735 ​N for 10 ​s in each group.</p></div><div><h3>Results</h3><p>The LET-ER group exhibited a statistically significant higher peak contact pressure compared to the LET-NR group. The peak contact pressure values in the LET-NR and LET-ER groups were 702.3 ​± ​233.9 ​kPa and 1235.5 ​± ​171.4 ​kPa, respectively (<em>p</em> ​= ​0.010, 95% CI, −888.0 to −178.5). The mean contact pressure values in the LET-NR and LET-ER groups were 344.9 ​± ​69.0 ​kPa and 355.3 ​± ​34.9 ​kPa, respectively (<em>p</em> ​= ​0.796, 95% CI, −105.1–84.2). The mean contact area values in the LET-NR and LET-ER groups were 36.8 ​± ​3.1 mm² and 33.3 ​± ​6.4 mm², respectively (<em>p</em> ​= ​0.360, 95% CI, −5.2–12.2).</p></div><div><h3>Conclusions</h3><p>The peak contact pressure of the lateral tibiofemoral joint is greater in LET when the graft is tensioned in external rotation than in neutral rotation. However, no statistically significant difference in the mean contact pressure or the mean contact area was observed between the two groups.</p></div><div><h3>Level of evidence</h3><p>III.</p></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000798/pdfft?md5=30167f1ce3b2f59f86238dcd872bcb6f&pid=1-s2.0-S2059775424000798-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of platelet-rich plasma in partial-thickness rotator cuff tears: a systematic review","authors":"","doi":"10.1016/j.jisako.2024.04.010","DOIUrl":"10.1016/j.jisako.2024.04.010","url":null,"abstract":"<div><h3>Importance</h3><p>Partial-thickness rotator cuff tears (PTRCTs) commonly affect overhead athletes, leading to a decline in sports performance. Platelet-rich plasma (PRP) is being explored as an alternative treatment modality for individuals with PTRCTs to reduce discomfort and enhance functional recovery. We conducted a systematic review study of randomized controlled clinical trials to determine the effectiveness of PRP in treating PTRCTs.</p></div><div><h3>Aim</h3><p>To determine the effectiveness of PRP in treating PTRCTs.</p></div><div><h3>Evidence review</h3><p>We conducted a comprehensive literature search for randomized controlled trials (RCTs) that compared the effectiveness of PRP with eccentric exercise and placebo injections as treatments for PTRCTs. We searched databases such as the Cochrane Library, Web of Science, PubMed, and EMBASE. The visual analog scale (VAS) score, American Shoulder and Elbow Surgeon (ASES) score, and Constant–Murley Score (CMS) was utilized as an outcome measure. Statistical analysis was performed using RevMan 5.3 software.</p></div><div><h3>Findings</h3><p>Our meta-analysis included 12 studies involving 762 patients. At six weeks post-treatment, the PRP group had significantly higher VAS scores compared to the control group, indicating improvement (standard mean difference (SMD): −2.04 [95% confidence interval (CI): −4.00 to −0.08], I² ​= ​97%, P-value ​= ​0.04). Patients who received PRP showed statistically significant improvements in VAS scores at 3 months and 6 months follow-up (SMD, −1.78 [95% CI: −3.03 to −0.52], I² ​= ​96%, P-value ​= ​0.005) (SMD: −2.26 [95% CI: −3.77 to −0.76], I² ​= ​97%, P-value ​= ​0.003). A statistically significant difference was also observed in VAS scores at the long-term 1-year follow-up (SMD: −2.27 [95% CI: −4.07 to −0.47]; I² ​= ​98%; P-value ​= ​0.031). There were statistically significant differences in ASES scores and CMS scores in the short-term (SMD: 1.21 [95% CI: 0.19 to 2.24], I² ​= ​96%, P-value ​= ​0.02) (SMD, 2.01 [95% CI: 0.14 to 3.88], I² ​= ​97%, P-value ​= ​0.04). However, in the long-term ASES and CMS scores did not show any statistical significance (SMD: 2.06 [95% CI: −0.54 to 4.65], I² ​= ​99%, P-value ​= ​0.12) (SMD: 4.36 [95% CI: −5.48 to 14.21], I² ​= ​99%, P-value ​= ​0.39).</p></div><div><h3>Conclusions and relevance</h3><p>Our findings suggest that PRP treatment is effective in reducing pain for individuals with PTRCTs, providing benefits in the short and long term. However, its impact on functional recovery appears somewhat constrained and doesn't endure over time. Additionally, significant heterogeneity exists among studies, encompassing variations in PRP composition and control group treatments. Consequently, we conclude that compelling evidence for symptom improvement in PTRCT patients following PRP treatment remains elusive.</p></div><div><h3>Level of","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2059775424000804/pdfft?md5=2e61c4d9c0cda74247b2aa0a61f826b8&pid=1-s2.0-S2059775424000804-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}