Progress and prospect of biological treatment for rotator cuff injury repair / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress in biotherapy of rotator cuff injury in recent years, in order to provide help for clinical decision-making of rotator cuff injury treatment.@*METHODS@#The literature related to biotherapy of rotator cuff injury at home and abroad in recent years was widely reviewed, and the mechanism and efficacy of biotherapy for rotator cuff injury were summarized from the aspects of platelet-rich plasma (PRP), growth factors, stem cells, and exosomes.@*RESULTS@#In order to relieve patients' pain, improve upper limb function, and improve quality of life, the treatment of rotator cuff injury experienced an important change from conservative treatment to open surgery to arthroscopic rotator cuff repair. Arthroscopic rotator cuff repair plus a variety of biotherapy methods have become the mainstream of clinical treatment. All kinds of biotherapy methods have ideal mid- and long-term effectiveness in the repair of rotator cuff injury. The biotherapy method to promote the healing of rotator cuff injury is controversial and needs to be further studied.@*CONCLUSION@#All kinds of biotherapy methods show a good effect on the repair of rotator cuff injury. It will be an important research direction to further develop new biotherapy technology and verify its effectiveness.

What do Cochrane Systematic Reviews say about conservative and surgical therapeutic interventions for treating rotator cuff disease? Synthesis of evidence

ABSTRACT BACKGROUND: Shoulder pain is considered to be the third largest cause of musculoskeletal functional alterations in individuals presenting pain during movement. OBJECTIVE: The purpose of this synthesis of evidence was to identify the clinical effectiveness of conservative and surgical treatments reported in Cochrane systematic reviews among individuals diagnosed with rotator cuff disease. DESIGNAND SETTING: Review of systematic reviews, conducted in the Federal University of São Paulo (Universidade Federal de São Paulo, UNIFESP). METHODS: This synthesis of evidence included systematic reviews that had been published in the Cochrane database. The inclusion criteria were that these systematic reviews should involve individuals aged ≥ 16 years with rotator cuff disease, comparing surgical procedures with or without associated nonsurgical procedures versus placebo, no treatment or other nonsurgical interventions. RESULTS: Thirty-one systematic reviews were included, involving comparisons between surgical procedures and conservative treatment; procedures either combined or not combined with drugs, versus other procedures; and procedures involving exercises, manual therapy and electrothermal or phototherapeutic resources. CONCLUSIONS: The findings suggest that strengthening exercises, with or without associated manual therapy techniques and other resources, were the interventions with greatest power of treatment over the medium and long terms, for individuals with shoulder pain. These had greater therapeutic power than surgical procedures, electrotherapy or photobiomodulation. Protocol registration number in the PROSPERO database: ID - CRD42018096578.

Terapia de ondas de choque en patología músculo-esquelética / Pathology shock wave therapy muscle-skeletal

Extracorporeal shock waves are unique sound waves that generate a rapid increase in pressure in the tissues in which they are applied. They were first used on the management of urolithiasis and later spread to other pathologies such as musculoskeletal. A series of studies have been carried out to support the usefulness of shock waves in patients with plantar fasciitis, Achilles tendinopathy, epicondylitis, rotator cuff injury with or without calcification, patellar tendinopathy and peritrochanteric pathology that has lasted more than three months and have not responded to the initial handling. There is no consensus regarding the specific protocols to be used. In these conditions, shock waves are only a part of a comprehensive treatment, and should always be associated with other conventional therapies. (AU)