Clinical Study Of Sodium Hyaluronate, Tranexamic Acid On Early And Middle Functional Recovery After Rotator Cuff Repair

Objective:To explore the effect of sodium hyaluronate and tranexamic acid on early and middle functional recovery after rotator cuff repair.Methods:From December 2016 to April 2018,40 patients with rotator cuff injury were enrolled in the Department of Osteoarthropathy and Sports Medicine,First Affiliated Hospital of Hunan Normal University.20 cases in group A were randomly divided into two groups.The experimental group received intra-articular injection immediately after the incision suture was completed: sodium hyaluronate(2.5 ml)+2 g tranexamic acid(diluted to 20 ml by normal saline).The control group received 20 cases in group B.The incision was sutured immediately after the operation.Injection: sodium hyaluronate(2.5 ml)+ saline 20 ml.Two groups were randomly divided by a fixed itinerant nurse before the end of operation,and then given to the chief knife doctor intra-articular injection according to the grouping situation.The whole process was strictly carried out in a double-blind randomized controlled manner.All selected cases were given ASES shoulder joint score,UCLA shoulder joint score,CONST before operation,1 week after operation,1 month after operation,3 months after operation and 6 months after operation,respectively.The project was approved by the Ethics Committee of Hospital Ethics and Medical Sciences.All patients signed the informed consent.Results:(1)There was no significant difference in ASES shoulder score,UCLA shoulder score,CONSTANT shoulder score,pain value(VAS),muscle strength,external rotation value and flexion value between the two groups(P > 0.05).(2)ASES shoulder score: There was no significant difference between group A(40.10±10.16)and group B(37.77±10.45)ASES shoulder score at 1 week after operation(P>0.05);group A(66.10(±8.67)and group B(58.69(±8.81),group A(80.86(±7.16)and group B(71.69(±7.74),group A(90.60(±5.36)at 1 month after operation.Compared with group B(83.19 ±8.13),there was significant difference in ASES shoulder score between the two groups.(3)Score of UCLA shoulder joint: AB group patients,group A preoperative(17.70±3.40)and group B preoperative(17.90 ±3.80),group A 1 week postoperatively(20.00±2.62)and group B 1 week postoperatively.There was no significant difference in UCLA score between group A(20.65±3.10),group A(25.45±2.56)and group B(23.90±2.36)at 1 month after operation(P>0.05),group A(28.90±2.10)and group B(26.85±2.28),group A(31.80±1.67)and group B(30.10±2.22)at 3 months after operation(P >0.05),and group A(31.80±1.67)and group B(30.10±2.22)at 6 months after operation.(4)CONSTANT shoulder joint score: There was no significant difference between group A(38.40±6.63)and group B(44.65±11.88),group A(52.60±7.62)and group B(49.10±9.80)before operation(P> 0.05),group A(66.45±5.16)and group B(61.60±6.50),and three months after operation(P>0.05).There were significant differences in the CONSTANT score between group B(71.95±6.65),group A(91.25±5.17)and group B(85.65±7.30)6 months after operation(P<0.05).(5)VAS pain assessment: patients in group A(6.65±1.22)and group B(7.00±1.21),group A(3.70±0.86)and group B(3.65±1.09),group A(2.35±0.75)and group B(2.40±1.10),group A(1.65±0.99)and group B(1.55±1.23),group A(3 months)and group B(1.55±1.23).There was no significant difference in pain between group B and group B at 6 months(0.65±0.59)and 6 months(0.70±0.73)(P > 0.05).(6)PROM evaluation: There were significant differences in the external rotation values between group A and group B at 1 month(6.00±1.59)and 1month(4.60±1.47),6 months(8.20±1.44)and 6 months(6.70±1.63)after operation(P<0.05).There was no significant difference in the anterior flexion value of cut-off points between the two groups before and after operation(P>0.05).(7)Muscle strength evaluation: Compared with AB group,there was significant difference in muscle strength between group A and group B 6months after operation(24.75±1.12)and 6 months after operation(23.00±2.51).Conclusions:1.Intra-articular injection of tranexamic acid and sodium hyaluronate is superior to sodium hyaluronate alone in early recovery of joint function,improvement of external rotation angle and muscle strength after rotator cuff repair.It is superior to sodium hyaluronate alone in respects of improving rotation angle and muscle strength.