ROTATOR MANŞET YIRTIĞI OLAN HASTALARDA DEKSTROZ PROLOTERAPİ VE TROMBOSİTTEN ZENGİN PLAZMA UYGULAMALARININ ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Amaç: Rotator manşet yırtığı olan hastalarda dekstroz proloterapisiyle trombositten zengin plazma uygulamasının ağrı, fonksiyonellik üzerine etkisini karşılaştırmak. Matreyal ve Method: Ultrasonla rotator manşet yırtığı olan hastalar iki gruba randomize edildi: Grup I yırtık üzerine dekstroz proloterapi enjeksiyonu (n=15), Grup II yırtık üzerine trombositten zengin plazma uygulaması (n=15). Sonuçlar ağrı için vizüel analog skala (VAS) (istirahatte, aktivite sırasında ve gece), omuz eklem hareket açıklığı ölçümü (EHA), fonksiyonellik için de omuz özürlülük ölçütü (OÖÖ) ve The University of California-Los Angeles skalası (UCLA) kullanılarak tedavi öncesi ve tedavi sonrası 4. hafta bitiminde değerlendirildi. Sonuçlar: 30 katılımcının omuz ağrısı ortalaması 6.6±2.3, ağrsı süresi ortalaması 4.2±1.6 idi. Demografik ve klinik özelliklerin ilk değerlendirmeleri gruplar arası benzerdi (p> 0.05). Grup içi tüm klinik parametrelerde düzelme vardı (p< 0.001). İlk ve son değerlendirme arasındaki farklar kıyaslandığında VAS, OÖÖ, UCLA değerlendirmelerinde iki grup arasında fark yokken, Grup II’deki EHA değişiminin Grup I’de istatistiksel olarak anlamlı düzeyde daha iyi olduğu gözlendi ( p<0.05). Sonuç: Her iki grupta da ağrı, EHA ve fonksiyonellikte belirgin düzelme gözlendi. Ağrı, fonksiyonellik açısından iki uygulamanın etkinliği benzerken EHA’daki düzelme açısından trombositten zengin plazma uygulanan grupta dektroz proloterapisi uygulanan gruptan daha belirgin düzelme izlenmişti. Onun için rotator manşette yırtığı olan hastalarda trombositten zengin plazma uygulaması tercih edilebilir.

THE COMPARISON OF DEXTROSE PROLOTHERAPY AND PLATELLET RICH PLASMA IN PATIENTS WITH ROTATOR CUFF TEARS

Objective: To compare the effect of dextrose prolotherapy and platellet rich plasma on pain, functionality levels in patients with rotator cuff tears. Materials/Methods: Patients with ultrasound-confirmed rotator cuff tear were randomly divided into two groups as follows; group I (n=15) (the injection of dextrose solution over tear) and the group II (n=15) (the injection of platelet rich plasma over tear). Outcome measures including visual analog scale (VAS) (pain at rest, during activity and at night), shoulder range of motions (ROMs), shoulder disability questionnaire (SDQ) and The University of California-Los Angeles scale (UCLA) were evaluated before (baseline) and after the treatment (4th week). Results: The 30 participants had shoulder pain (6.6±2.3) for 4.2±1.6 months. Demographic and baseline clinical characteristics of the groups were similar between the groups (p> 0.05). Within each group, significant improvements were observed in all clinical variables (p< 0.001). There was no significant differences in the changes in outcome scores (VAS, SDQ, UCLA) (according to baseline values) between the groups ( p<0.05). But Group II was superior to Group I in the changes in ROM. Conclusion: We found a significant improvement in terms of pain, ROM and functionality in both groups. In participants with rotator cuff tear, the injection of platellet rich plasma over tear area resulted in superior ROM improvement compared with dextrose injection. The injection of platellet rich plasma may improve upon dextrose injection for patients with shoulder pain.

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