The aim of this study is to establish if the application of autologous conditioned plasma (ACP), also described as platelet rich plasma (PRP), to the site of supraspinatus tendon repair beginning within two weeks of surgery, can improve patient outcomes over the course of 12 months. These outcomes will be measured by post-surgical pain and function scores, shoulder strength and range of motion (ROM), and radiological parameters of tendon healing. Outcome measures will be compared to a control group of patients receiving placebo injections following surgery (saline plus local anaesthetic). This study is significant for being the first double blind randomised control trial, using two PRP injections to examine the efficacy of a PRP preparation following surgical repair of supraspinatus tendon. The objective is to prolong and enhance the tendon healing response initiated by surgery. The research hypothesis is that enhanced tendon healing following the PRP injections will lead to more rapid rehabilitation and lower rates of re-rupture of the repaired tendon compared to the control group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
60
10ml of patient's own venous blood is aspirated. ACP (1ml) (extracted from centrifuged venous sample), with additional calcium chloride is then injected into the tendon-bone junction and adjacent area under guided ultrasound. * First injection at approximately 10 days post-operatively * Second Injection at approximately 21 days post-operatively
10ml of patient's own venous blood is aspirated. The syringe is centrifuged in a proprietary closed unit (Arthrex Medical Company) for 5 minutes. The venous blood sample will be discarded and a placebo (1ml saline + local anaesthetic) is injected to the surrounding tissue, but not into the tendon, under guided ultrasound. * First injection at approximately 10 days post-operatively * Second Injection at approximately 21 days post-operatively
Fremantle Hospital Radiology Department
Fremantle, Western Australia, Australia
Changes in magnetic resonance imaging (MRI) score over time
MRI will assess the dimensions of the supraspinatus tear pre-operatively. MRI will assess the tendon healing of the supraspinatus tendon post-operatively at 12 months
Time frame: Pre-operatively, and 12 months post-operatively
Changes in shoulder range of motion over time
Shoulder range of motion measures will include: * internal humeral rotation of the affected arm * external humeral rotation of the affected arm * forward flexion of the affected arm * abduction of the affected arm
Time frame: pre-operatively, 3 months post-operatively, 6 months post-operatively, 12 months post-operatively
Changes in strength of the shoulder musculature over time
Muscular strength will be measured through: * internal humeral rotation of the affected arm * external humeral rotation of the affected arm * forward flexion of the affected arm * abduction of the affected arm
Time frame: 6 months post-operatively, 12 months post-operatively
Changes in the visual analogue scale (VAS) for pain over time
The VAS is a scale from 1 to 10 and requires the patient to rate their pain along the scale; with 0 equating to no pain and 10 equating to the worst possible pain.
Time frame: Pre-operatively, 1st injection post-operatively, 2nd injection post-operatively, 6 weeks post-operatively, 12 weeks post-operatively, 6 months post-operatively, 12 months post-operatively
Changes in the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire over time
The QuickDASH is a shortened version of the Disabilities of the Arm Shoulder and Hand (DASH) outcome measure. It uses 11 items instead of the original 30 items to measure physical function and symptoms in persons with any or multiple musculoskeletal disorders of the upper arm.
Time frame: Pre-operatively, 6 weeks post-operatively, 12 weeks post-operatively, 6 months post-operatively, 12 months post-operatively
Changes in the Oxford Shoulder Score (OSS) over time
The OSS is a self-reported questionnaire developed to evaluate disability in those with injuries and impairment of the rotator cuff.
Time frame: Pre-operatively, 6 weeks post-operatively, 12 weeks post-operatively, 6 months post-operatively, 12 months post-operatively
Changes in the Simple Shoulder Test (SST) over time
The SST consists of a series of 12 "yes" or "no" questions regarding function of the involved shoulder.
Time frame: Pre-operatively, 6 weeks post-operatively, 12 weeks post-operatively, 6 months post-operatively, 12 months post-operatively
Changes in the Short Form - 12 health questionnaire (SF-12) over time
The SF-12 is a shortened version of the Short Form-36 (SF-36). It uses 12 items instead of 36, to measure general functional health and well-being from the patient's point of view.
Time frame: Pre-operatively, 6 weeks post-operatively, 12 weeks post-operatively, 6 months post-operatively, 12 months post-operatively
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