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El Plasma Rico en Plaquetas mejor tratamiento que los corticoides para la Tendinopatía glutea-trocanteritis

El Plasma Rico en Plaquetas mejor tratamiento que los corticoides para la Tendinopatía glutea-trocanteritis
25 marzo, 2018 SportMe

There would be no difference in the modified Harris Hip Score (mHHS) between a single platelet-rich plasma (PRP) injection compared with a corticosteroid injection in the treatment of gluteal tendinopathy.

Randomized controlled trial; Level of evidence, 1.

There were 228 consecutive patients referred with gluteal tendinopathy who were screened to enroll 80 participants; 148 were excluded (refusal: n = 42; previous surgery or sciatica: n = 50; osteoarthritis, n = 17; full-thickness tendon tear, n = 17; other: n = 22). Participants were randomized (1:1) to receive either a blinded glucocorticoid or PRP injection intratendinously under ultrasound guidance. A pain and functional assessment was performed using the mHHS questionnaire at 0, 2, 6, and 12 weeks and the patient acceptable symptom state (PASS) and minimal clinically important difference (MCID) at 12 weeks.

Participants had a mean age of 60 years, a ratio of female to male of 9:1, and mean duration of symptoms of >14 months. Pain and function measured by the mean mHHS showed no difference at 2 weeks (corticosteroid: 66.95 ± 15.14 vs PRP: 65.23 ± 11.60) or 6 weeks (corticosteroid: 69.51 ± 14.78 vs PRP: 68.79 ± 13.33). The mean mHHS was significantly improved at 12 weeks in the PRP group (74.05 ± 13.92) compared with the corticosteroid group (67.13 ± 16.04) (P = .048). The proportion of participants who achieved an outcome score of ≥74 at 12 weeks was 17 of 37 (45.9%) in the corticosteroid group and 25 of 39 (64.1%) in the PRP group. The proportion of participants who achieved the MCID of more than 8 points at 12 weeks was 21 of 37 (56.7%) in the corticosteroid group and 32 of 39 (82%) in the PRP group (P = .016).

Patients with chronic gluteal tendinopathy >4 months, diagnosed with both clinical and radiological examinations, achieved greater clinical improvement at 12 weeks when treated with a single PRP injection than those treated with a single corticosteroid injection.

PRP TROCANTERITIS SPORTME

Comments (2)

  1. jennie 6 meses hace

    Buenos días, podrían por favor ayudarme con una consulta, desde hace 9 meses tengo un dolor a nivel ingle ( cuando me paro o estiro la pierna) acompañado de un dolor en la cadera ( en la parte lateral a la altura de la inserción de huesos), los estudios radiológicos y de resonancia magnética no muestran ninguna alteración pero clínicamente me diagnosticaron bursitis, y me sugirieron una infiltración ( un doctor me sugirió de plasma otro de corticoide). Cuales son los efectos secundarios de ambos tipos de infiltración y cual es menos dañiño.

    • Autor
      SportMe 6 meses hace

      Hola Jenny en el caso de obtener una bursitis trocantérea ica o hilio psoas nosotros comenzamos con una terapia ecoguiada administrando cortisona en un primer intento dejando la terapia biológica con plasma rico en plaquetas para la ocasión en que no surja efecto los efectos secundarios de ambas terapias son mínimos pero le insisto que es lo más importante es confirmar un diagnóstico de certeza habría que descartar un pinzamiento femoroacetabular o rotura del labrum

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