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Decreased Synovial Fluid Biomarkers Levels Are Associated with Rehabilitation of Function and Pain in Rotator Cuff Tear Patients Following Electroacupuncture Therapy

Jian Guan, Wei-Qiang Geng, Yao Li, Guang-Yuan Liu, Luo-Bin Ding, You-Jie Liu, Wei Xue, Huajun Wang, Xiao-Fei Zheng

Department of Orthopedic Surgery, Third Hospital of Shijiazhuang, Shijiazhuang, Hebei, China (mainland)

Med Sci Monit 2020; 26:e923240

DOI: 10.12659/MSM.923240

Available online: 2020-07-16

Published: 2020-09-11

BACKGROUND: The aim of this study was to assess inflammatory cytokines levels in synovial fluid (SF) before and after electroacupuncture (EA) treatment and to explore whether these biomarkers are associated with function of rotator cuff tear (RCT) patients.
MATERIAL AND METHODS: We recruited 54 patients with RCT and separated them into an EA group and a control group. The SF biomarker levels were detected at baseline and at 6-week and 6-month follow-up. The symptomatic severity was evaluated by visual analog scale (VAS), Constant-Murley score, and American Shoulder and Elbow Surgeons score (ASES). We also investigated the correlation between symptomatic severity and biomarker levels in SF of the shoulder joint.
RESULTS: The reductions in VAS and improved functional score (ASES and Constant-Murley score) were significantly different between the 2 groups, and SF biomarker concentrations were significantly lower in the EA group. IL-1ß levels were significantly negatively correlated with Constant-Murley score (r=-0.73, P=0.04) and ASES score (r=-0.59, P<0.001) and positively correlated with VAS scores (r=0.81, P=0.004). IL-6 levels were significantly negatively correlated with Constant-Murley score (r=-0.67, P=0.03) and positively correlated with VAS score (r=0.7, P=0.01). MMP-1 levels were significantly negatively correlated with ASES score (r=-0.57, P<0.001).
CONCLUSIONS: The biomarkers in SF were directly associated with shoulder pain and shoulder function in rotator cuff tear. EA, as a safe and effective conservative therapy, obviously decreased the level of inflammatory cytokines in RCT patients, accompanied by a reduction in shoulder pain and improved function.

Keywords: Biological Markers, Electroacupuncture, Inflammation, rotator cuff, Synovial Fluid