Tuesday, June 18, 2024

Comparative Study of BMC Treatment and Home Exercise Therapy for Supraspinatus Tears

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In recent years, the debate between surgical and non-surgical treatments for high-grade partial and full-thickness rotator cuff tears has intensified. A new study explores an alternative: percutaneous orthobiologic treatment versus home exercise therapy specifically for supraspinatus tears. This research could significantly impact how such injuries are managed in the future.

Study Design and Methodology

The study employed a randomized-controlled, crossover design where participants with torn supraspinatus tendons were assigned to either a ‘BMC treatment’ group, receiving a combination of autologous bone marrow concentrate (BMC) and platelet products, or to a home exercise therapy program. After three months, those in the exercise group unsatisfied with their shoulder progression were allowed to crossover to the BMC treatment. Researchers collected patient-reported outcomes on the Numeric Pain Scale (NPS), Disabilities of the Arm, Shoulder, and Hand (DASH), and a modified Single Assessment Numeric Evaluation (SANE) at multiple intervals up to 24 months. Pre- and post-treatment MRIs were evaluated using the Snyder Classification system.

Findings and Results

Out of 51 patients, 34 were randomized to the BMC treatment group and 17 to the exercise therapy group. The BMC group demonstrated significantly greater improvements in median ΔDASH, ΔNPS, and SANE scores compared to the exercise group (-11.7 vs -3.8, P = 0.01; -2.0 vs 0.5, P = 0.004; and 50.0 vs 0.0, P

Actionable Insights

– BMC treatment offers significantly better outcomes in pain reduction and functional improvement compared to home exercise therapy.
– Patient satisfaction appears higher with BMC treatment, with many opting to crossover from the exercise group.
– Long-term follow-up suggests sustained benefits of BMC treatment without serious adverse effects.
– MRI evidence supports the healing efficacy of BMC treatment in a majority of patients.

In conclusion, the study reveals that BMC treatment leads to significantly greater improvements in function, pain relief, and overall patient satisfaction compared to a home exercise therapy program for high-grade partial and full-thickness supraspinatus tears. This could pave the way for BMC treatment to become a more widely accepted alternative to surgery and traditional therapies.

Original Article: BMC Musculoskelet Disord. 2024 May 18;25(1):392. doi: 10.1186/s12891-024-07519-6.

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