Abstract
Aims: Healing of the rotator cuff after surgical repair continues to be one of the most challenging areas of shoulder surgery. Autologous Platelet Derived Grow Factors (PDGF) have been shown to positively affect the tissue healing, but their effect have not been studied in relation to tendon healing. The purpose of this study is to evaluate if the use of PDGF in rotator cuff surgery could lead to a better and faster healing of the repair.
Materials e Methods: We treated two groups (A,B) of 14 shoulders in 14 patients (mean age 66 and 63.4) with a full thickness rotator cuff tear. The group A and B were treated with a full arthroscopic repair of the cuff. In the group A, at the end of the procedure, the PDGF have been injected at the level of the lesion, between the tendon and the bone and over the tendon repair without irrigation and after the removal of all the cannulas. The group B, repaired in the same fashion, without PDGF, has been used as control.
In the group A the patients had an accelerated postop. rehabilitation. The group B received a standard rehabilitation protocol. Each group has been evaluated prospectively with VAS, UCLA and Constant scores pre-op and during follow-up.
Results: Both group showed an increase of the scores, compared to the pre-op. value (tab.1).
The VAS score of group A (PDGF) was pre-op. 5.6 and at 1 year 1.4. The VAS score of group B (no PDGF) was pre-op. 5.2 and at 1 year 1.4. The UCLA score of group A was pre-op. 16 and at 1 year 33.8. The UCLA score of group B was pre-op. 16.7 and at 1 year 32.9. The Constant score of group A was pre-op. 53 and at 1 year 90.7. The Constant score of group B was pre-op. 54.2 and at 1 year 90.1.
The complete statistical analysis of the data showed no significant differences in the results of the two groups (p< 0,01), with every kind of scores, VAS, UCLA and Constant, at the final follow-up of 1 year.
Conclusions: Our data suggest that the use of PDGF, compared to a standard repair, does not affect the quality of the rotator cuff repair at 1 year. Moreover the study suggest that the use of PDGF allows an accelerated rehabilitation program with ten days of immobilization compared to four weeks as usually prescribed. Further studies should clarify the real effect of PDGF about the acceleration of the first phase of the cuff healing.
The abstracts were prepared by incoming Professor Elena Brach del Prever. Correspondence should be addressed to IORS – President office, Dipartimento di Traumatologia, Ortopedia e Mediciana del Lavoro, Centro Traumatologico Ortopedico - Via Zuretti, 29 I-10135 Torino, Italy.
