Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome. A prospective randomized double-blind study.
BACKGROUND
Platelet-leukocyte gel (PLG) is being used during various surgical procedures in an attempt to enhance the healing process. We studied the effects of PLG on postoperative recovery of patients undergoing open subacromial decompression (OSD).


METHODS
PLG was produced from platelet-leukocyte-rich plasma (P-LRP), prepared from a unit of whole blood. Forty patients were included in the study. Self-assessed evaluations, using the American Shoulder and Elbow Surgeons scoring system of activities of daily living (ADL), joint instability, pain levels, pain medications, and clinical evaluations for range of motion were conducted.


RESULTS
Platelet and leukocyte counts were significantly increased in the P-LRP compared to baseline counts. Treated patients demonstrated decreased visual analog scales for pain and used significantly less pain medication, had an improved range of motion during passive forward elevation, external rotation, external rotation with arm at 90 degrees abduction, internal rotation, and cross body adduction compared to control patients (p < 0.001). No differences in the instability score were observed between the groups. Furthermore, treated patients performed more ADL (p < 0.05).


CONCLUSIONS
In the PLG-treated group, recovery was faster and patients returned earlier to daily activities and also took less pain medication than control subjects.
Everts
P A
PA
Department of Peri-Operative Blood Management, Catharina Hospital, Eindhoven, The Netherlands. everts@elive.nl
Devilee
R J J
RJ
Brown Mahoney
C
C
van Erp
A
A
Oosterbos
C J M
CJ
Stellenboom
M
M
Knape
J T A
JT
van Zundert
A
A
D000328:Adult; D001792:Blood Platelets; D019299:Decompression, Surgical / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005782:Gels; D006801:Humans; D007270:Injections, Intra-Articular; D007430:Intraoperative Care; D007593:Joint Instability / Q000209:etiology; D007958:Leukocyte Count; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D010976:Platelet Count; D011184:Postoperative Period; D016059:Range of Motion, Articular; D019534:Shoulder Impingement Syndrome / Q000097:blood* / Q000601:surgery*; D012785:Shoulder Joint; D016896:Treatment Outcome
D005782:Gels