A Pilot Study Evaluating the Effectiveness of Platelet-Rich Plasma Therapy for Treating Degenerative Tendinopathies: A Randomized Control Trial with Synchronous Observational Cohort.

OBJECTIVE: This pilot study aimed to inform future research evaluating the effectiveness of Platelet Rich Plasma (PRP) injection for tendinopathy. DESIGN: Randomized control trial (RCT) and synchronous observational cohort studies. For the RCT, consecutive consenting patients treated at an academic sports medicine clinic were randomly assigned to either a PRP or placebo control group. SETTING: The Glen Sather Sport Medicine Clinic, Edmonton, Canada. PATIENTS: The RCT included 9 participants with rotator cuff tendinopathy. The cohort study included 178 participants with a variety of tendinopathies. INTERVENTIONS: Patients receiving PRP were injected with 4 ml of platelets into the supraspinatus and/or infraspinatus, while patients in the placebo group were injected with 4 ml of saline. All participants undertook a 3-month standardized, home-based, daily exercise program. MAIN OUTCOME MEASURES: Participants in the RCT were re-evaluated 3, and 6 months post-injection. Change scores before and after injection on pain, disability and MRI-documented pathology outcomes were compared. In the cohort study, pain and disability were measured at 1, 2 and 3 months post-injection. RESULTS: For the RCT, 7 participants received PRP and 2 received placebo injections. Patients receiving PRP reported clinically important improvements in pain (>1.5/10 on VAS), disability (>15 point DASH change), and tendon pathology while those receiving placebo injections did not. In the observational cohort, statistically and clinically significant improvements in pain and disability were observed. CONCLUSION: This pilot study provides information for planning future studies of PRP effectiveness. Preliminary results indicate intratendinous, ultrasound-guided PRP injection may lead to improvements in pain, function, and MRI-documented tendon pathology. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN68341698.

Long-term sequelae of electrical injury.

OBJECTIVE: To summarize the current evidence-based knowledge about the long-term sequelae of injuries from electrical current. QUALITY OF EVIDENCE: MEDLINE was searched for English-language articles published in the past 20 years using the following search terms: electrical, injuries, wound, trauma, accident, sequelae, long-term, follow-up, and aftereffects. For obvious reasons, it is unethical to randomly study electrical injury in controlled clinical trials. By necessity, this topic is addressed in less-rigorous observational and retrospective work and case studies. Therefore, the strength of the literature pertaining to the long-term sequelae of electrical injury is impaired by the necessity of retrospective methods and case studies that typically describe small cohorts. MAIN MESSAGE: There are 2 possible consequences of electrical injury: the person either survives or dies. For those who survive electrical injury, the immediate consequences are usually obvious and often require extensive medical intervention. The long-term sequelae of the electrical injury might be more subtle, pervasive, and less well defined, but can include neurologic, psychological, and physical symptoms. In the field of compensation medicine, determining causation and attributing outcome to an injury that might not result in objective clinical findings becomes a considerable challenge. CONCLUSION: The appearance of these consequences of electrical injury might be substantially delayed, with onset 1 to 5 or more years after the electrical injury. This poses a problem for patients and health care workers, making it hard to ascribe symptoms to a remote injury when they might not arise until well after the incident event.

An evaluation of Think First Saskatchewan: a head and spinal cord injury prevention program.

OBJECTIVES: To identify youth behaviour with regards to injury prevention, to assess the awareness of severity and susceptibility to brain and spinal cord injury, and to evaluate the impact of the Think First Saskatchewan school visit program on students' knowledge of brain and spinal cord injury prevention. METHODS: A controlled, pre- and post-test design, self-report questionnaire was administered to 1,257 grade 6 and 7 students. Descriptive statistics and chi-square were used for data analysis. P-values less than 0.05 were considered significant. RESULTS: Saskatchewan youth participate in activities that put them at risk for brain and spinal cord injury. The Think First Saskatchewan school visit program statistically improved self-reported knowledge of the students receiving the Think First message. DISCUSSION: Think First Saskatchewan is a brain and spinal cord injury prevention program that significantly improves youth knowledge pertaining to injury prevention. Further evaluation of the program to include a more delayed survey of retention of knowledge, changes to behaviour, and reduction of brain and spinal cord injury are necessary.