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Abstract
Tendons have limited reparative ability and perform a relatively simple mechanical function via the extracellular matrix. Thus, the injured tendon might be treated successfully by stem cell transplantation. We performed a randomized, controlled study to investigate the effects of mesenchymal stem cell injection for treating partial tears in the supraspinatus tendon. We enrolled 24 patients with shoulder pain lasting more than 3 months and partial tears in the supraspinatus tendon. Participants were assigned to three groups: stem cells in fibrin glue, normal saline/fibrin glue mixture, and normal saline only, with which intra-lesional injection was performed. Pain at activity and rest, shoulder function and tear size were evaluated. For safety measures, laboratory tests were taken and adverse events were recorded at every visit. Participants were followed up at 6, 12 weeks, 6, 12 months and 2 years after injection. The primary outcome measure was the improvement in pain at activity at 3 months after injection. Twenty-three patients were included in the final analysis. Primary outcome did not differ among groups (p = 0.35). A mixed effect model revealed no statistically significant interactions. Only time significantly predicted the outcome measure. All participants reported transient pain at the injection site. There were no differences in post-injection pain duration or severity. Safety measures did not differ between groups, and there were no persistent adverse events. Stem cell injection into supraspinatus partial tears in patients with shoulder pain lasting more than 3 months was not more effective than control injections.
ClinicalTrials.gov Identifier: NCT02298023
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1 Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Department of Rehabilitation Medicine, Changwon, Republic of Korea
2 University of Ulsan College of Medicine, Department of Rehabilitation Medicine, Asan Medical Center, Seoul, Republic of Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667); Seoul National University, Department of Rehabilitation Medicine, College of Medicine, Seoul, Republic of Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905)
3 Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Department of Rehabilitation Medicine, Seoul, Republic of Korea (GRID:grid.31501.36)
4 Seoul National University Hospital, Department of Rehabilitation Medicine, Seoul, Republic of Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X)
5 Seoul National University Hospital, Department of Rehabilitation Medicine, Seoul, Republic of Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X); Seoul National University, Department of Rehabilitation Medicine, College of Medicine, Seoul, Republic of Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905)
6 Armed Forces Daejeon Hospital, Daejeon, Republic of Korea (GRID:grid.31501.36)
7 Sungkyunkwan University School of Medicine, Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
8 Seoul National University College of Medicine, Department of Radiology, Seoul, Republic of Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905)
9 Seoul National University Hospital, Department of Radiology, Seoul, Republic of Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X)
10 Seoul National University, Department of Rehabilitation Medicine, College of Medicine, Seoul, Republic of Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905); Seoul National University Hospital, Department of Rehabilitation Medicine, Seoul, Republic of Korea (GRID:grid.412484.f) (ISNI:0000 0001 0302 820X); Seoul National University, Institute of Aging, Seoul, Republic of Korea (GRID:grid.31501.36) (ISNI:0000 0004 0470 5905)