ABSTRACT
Background: Rotator cuff tendinopathy (RCT) is a main source of disability work inefficiency and overall inefficiency. Platelet-rich plasma (PRP) has been postulated to be of great advantage in the management of RCT. Steroidal formulations are base of all joint morbidities since long for inflammatory and degenerative conditions in orthopedics. Aim and Objectives: The aim of the study was to compare the effect of PRP injections versus steroid Injection (triamcinolone) in subacromial space on pain control and improved shoulder functions in patients having chronic RCT. Study Design: This study was a randomized controlled trial and level of evidence. Materials and Methods: The study was conducted in the Orthopaedics Department of GMC, Patiala on 40 patients (aged more than 18 years) who presented in emergency and Outpatient Department with symptoms of shoulder pain and decreased mobility at shoulder. The patients were divided into two groups. Every odd number of patient presenting to us was given PRP injection (Study group) and every even number patient was given inj triamcinolone (control group) along with physical therapy in both study and control group. Patient was followed up subsequently after 4-week and 12-week time for resolution of symptoms and improved pain-free activities. Outcome assessment criterion used included VAS system and Oxford Shoulder Scoring System. Results: Comparison of the patients in the two groups revealed significant difference between the groups in VAS and OSS at 4-week and 12-week follow-ups. Long-term effect was more in case of PRP group as compared to steroid formulation which was almost similarly effective acutely. Conclusion: Subacromial PRP injection was found to be more effective in long-term in improving overall quality of life, disability, pain, improved work efficiency, and improved shoulder movements in patients with chronic RCT than those treated by subacromial steroidal injection along with exercise program.
ABSTRACT
Background: The knee joint gets injured commonly as it has less musculature anteriorly and due to external forces affecting knee movements in coronal and sagittal planes. Rotational injuries are also common at the knee. Aims and Objectives: We wanted to compare the diagnostic capabilities of magnetic resonance imaging (MRI) and diagnostic arthroscopy (DgAr) in the evaluation of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus (MM), and lateral meniscus (LM) injuries etc., seek correlation among both MRI and DgAr knee and find the better modality. Materials and Methods: This prospective study involved 50 patients suffering from knee joint injuries in our tertiary care teaching hospital. MRI of the knee was done in knees with internal derangement; all patients went for arthroscopy under general/spinal anesthesia. Keeping DgAr as reference, MRI was compared on parameters such as sensitivity and specificity, positive and negative predictive value plus accuracy. Results: MRI had a high accuracy i.e. 91.1%, 94%, 86%, and 92% for ACL, PCL, MM, and LM, respectively. Furthermore, it had low positive predictive value (PPV) and High PPV for meniscal and cruciate injuries. Conclusion: MRI is commonly used to evaluate various structures of the knee. In cases where clinical findings favor meniscal or ACL injuries, MRI scan prior to arthroscopic examination does not offer additional advantage. We suggest early DgAr as appropriate intervention in such cases.