Effects of bone marrow aspirate concentrate and platelet-rich plasma on patients with partial tear of the rotator cuff tendon

Abstract

BackgroundWe compared the clinical course of rotator cuff tears between rotator cuff exercise and bone marrow aspirate concentration (BMAC)-platelet rich plasma (PRP) injection to identify the therapeutic effects of BMAC-PRP on partial tear of the rotator cuff tendon.MethodsTwenty-four patients with partial tear of the rotator cuff tendon participated in this study. Twelve patients underwent extraction of BMACs and PRP and received the injection of BMAC-PRP at the tear site under ultrasound guidance. Twelve patients in the control group were asked to perform the rotator cuff exercise for 3 months. Visual analog scale (VAS) and manual muscle test (MMT) scores of the supraspinatus muscle were measured, and the American Shoulder and Elbow Surgeons (ASES) score was recorded before, 3 weeks, and 3 months after injection. Tear size was measured by the greatest longitudinal tear length.ResultsThe change in the VAS differed between groups at 3 months (P = 0.039) but not at 3 weeks (P = 0.147). The ASES scores in the BMAC-PRP group changed from 39.4 ± 13.0 to 54.5 ± 11.5 at 3 weeks and 74.1 ± 8.5 at 3 months while those in the control group changed from 45.9 ± 12.4 to 56.3 ± 12.3 at 3 weeks (P = 0.712) and 62.2 ± 12.2 at 3 months (P = 0.011). The tear size decreased at 3 weeks or 3 months after the BMAC-PRP injection but was not significantly different from that in the control group.ConclusionsBMAC-PRP improved pain and shoulder function in patients with partial tear of the rotator cuff tendon.Trial registrationThe patients were registered in the institutional board registry of Samsung Medical Center (registry number 2014-07-173).Electronic supplementary materialThe online version of this article (10.1186/s13018-017-0693-x) contains supplementary material, which is available to authorized users.

A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis

“…Exercise therapy patients completed the stretching, strengthening, and stability exercises at home, with the opportunity to cross over to the treatment group after at least 3 months of the home exercise program if desired improvement was lacking. The duration of three months of exercise therapy is in line with other published research using exercise therapy for torn rotator cuffs [4,21,32,33]. Patients were followed for 24 months after receiving BMC treatment.…”

“…As an alternative treatment, early research on regenerative therapies such as platelet-rich plasma (PRP) and bone marrow concentrate (BMC) has shown promise in enhancing the healing properties of torn rotator cuff tendons, reducing retear rates over time, and improving symptoms and function [20][21][22]. BMC contains mesenchymal stem cells (MSCs) which are multipotent, readily available, and immune-privileged that contribute to tissue healing.…”

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

“…Moreover, BMMSCs support the recruitment of cells to neoangiogenic treatment sites to accelerate local revascularization [ 10 ]. Kim et al demonstrated that in the absence of an adequate scaffold, the survival rate of BMMSCs and their reparative and differentiation capacity to enhance healing are jeopardized [ 178 ]. Although tissue harvesting, specimen preparation, and mechanism of action are different for PRP and BMACs, studies have shown that they can complement each other [ 179 , 180 ].…”

The efficacy and safety of platelet-rich fibrin for rotator cuff tears: a meta-analysis

“…Platelet-rich plasma (PRP) is a whole-blood fraction containing high platelet concentrations, which can release various growth factors mentioned above to promote healing [ 7 ]. Studies have reported that PRP can be used in the management of tendinopathy [ 8 , 9 ].…”