Editorial Commentary: Platelet-Rich Plasma in the Treatment of Rotator Cuff Tears—From Hero to Zero?

Gwinner, Clemens; Scheibel, Markus

doi:10.1016/j.arthro.2019.11.105

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…PRP does seem to play an effective role in significantly reducing the retear rate in acute rotator cuff tears and in preventing full-blown large tears in chronic rotator cuff tendinopathies [39]. Since the retear rates after an arthroscopic repair of rotator cuff tear continue to be quite high, biologic methods of managing rotator cuff pathologies like PRP are gaining traction since they are said to improve bone-tendon healing, thereby reducing the chances of rupture, tear, or retears [40]. A rotator cuff tendinopathy is characterized by the presence of numerous microtears that possess the ability to transform into a full-blown tear.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Platelet-Rich Plasma Injection in the Management of Rotator Cuff Tendinopathy: A Review of the Current Literature

Bhan¹,

Singh²

2022

Cureus

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Platelet-rich plasma (PRP) is being projected as a newer and superior treatment option for rotator cuff tendinopathy. With the first use of PRP in trauma and orthopedics dating back only to 1998, its advent into the field is relatively recent. Thus, data on long-term efficacy, large cohort studies, or large randomized controlled trials are fairly limited. Moreover, owing to the absence of standardized methods of platelet extraction and lack of consensus on the ideal concentration of platelets in PRP, data comparison from different studies is difficult. Things are complicated by the fact that it is also not clear whether a single injection of PRP is therapeutic or if multiple serial injections are needed to produce the desired effects. The literature on efficacy and pain relief is also obtained from studies with low sample sizes and short followups. The dropout rate and noncompliance rate were also found to be high in some studies. Thus, the data is often not clinically significant and may also be biased due to the non-standardized inclusion and exclusion criteria of the studies. Though multiple studies have suggested good pain control with PRP injection, many studies have found that PRP injection therapy may not be any better than the physical therapy regimen prescribed to patients with rotator cuff tendinopathy. Also, the data on the efficacy of PRP on shoulder function and shoulder range of motion is at variance. This submission aims to evaluate the efficacy and use of PRP in the management of rotator cuff tendinopathy.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Platelet-Rich Plasma Injection in the Management of Rotator Cuff Tendinopathy: A Review of the Current Literature

Bhan¹,

Singh²

2022

Cureus

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“…38,40 Therefore, many efforts have been made to optimize the biologic environment, achieve biological integration of the tendon, and improve the rate and quality of healing of the rotator cuff tendon using platelet-rich plasma or stem cells. 14,17,30,44 Bone marrow stimulation (BMS) is one biologic approach to improve healing rates by creating multiple channels between bone marrow and the tendon footprint and recruiting the biologic elements, including bone marrow-derived mesenchymal stem cells (MSCs) and growth factors, to the repair site of the rotator cuff tendon. 3,21 With increasing interest in BMS for rotator cuff tears, many clinical studies have been conducted to evaluate the efficacy of BMS in RCR.…”

mentioning

confidence: 99%

Effect of Bone Marrow Stimulation on Arthroscopic Rotator Cuff Repair: A Systematic Review and Meta-analysis

Shin,

Kim,

Jang

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Arthroscopic rotator cuff repair (RCR) is a common orthopaedic procedure, but it has a high rate of retears that can negatively affect the functional outcomes. Bone marrow stimulation (BMS) has been suggested as an additional treatment to improve the outcomes of RCR. Purpose: To compare the effectiveness of the BMS procedure during RCR with conventional RCR. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic literature search was conducted in MEDLINE/PubMed, Embase, Cochrane Library, and Scopus, on March 1, 2023, for studies comparing postoperative retear rates and functional outcomes between patients who underwent primary arthroscopic RCR with and without the BMS procedure. Only level 1 and 2 randomized controlled trials with a minimum 12-month follow-up were included. The primary outcomes were retear rates and functional outcomes as measured by the Constant; American Shoulder and Elbow Surgeons (ASES); and University of California, Los Angeles (UCLA) scores and by postoperative range of motion. Subgroup analyses were performed based on repair technique (single-row repair vs double-row or suture-bridge repair). The standardized mean difference (SMD) and odds ratio (OR) were utilized to synthesize continuous and dichotomous outcomes, respectively. Homogeneity was evaluated using the chi-square test and I2 statistic. Results: The literature search yielded 661 articles, of which 6 studies (522 patients; 261 with BMS, 261 without BMS) met the eligibility criteria. The combined analysis showed no significant decrease in retear rates with the utilization of the BMS procedure during RCR (OR, 0.60; 95% CI, 0.35 to 1.03; P = .07; I2 = 24%). There was no significant intergroup difference in functional outcomes (Constant score: SMD, 0.13; 95% CI, –0.04 to 0.31; P = .13; I2 = 0%; ASES score: SMD, 0.04; 95% CI, –0.20 to 0.28; P = .73; I2 = 0%; UCLA score: SMD, –0.13; 95% CI, –0.50 to 0.23; P = .47; I2 = 0%). Subgroup analyses revealed no significant differences in postoperative retear risk or total Constant score according to the repair technique. Conclusion: Based on the available evidence, this systematic review did not find a significant benefit of the BMS procedure at the footprint during arthroscopic RCR compared with conventional RCR in terms of retear rates and functional outcomes at short-term follow-up.

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“…1,16,22 Biologic augmentation is also a strategy that has been developed and is considered relevant for improving the rate and quality of healing. [9][10][11]18,19,32 The use of platelet-rich plasma, growth factor, patches, and bone marrow stimulation are procedures that promote biologic processes in the healing response. 4,7,9,13 The crimson duvet procedure (CDP) was proposed to be applied in shoulder rotator cuff repair by Snyder in 2009, with the objective of providing mesenchymal stem cells through microfracture of the footprint.…”

mentioning

confidence: 99%

Functional and radiologic results of the crimson duvet procedure in rotator cuff treatment: a randomized controlled clinical trial

Toro

Pinochet

Ruíz

et al. 2022

Journal of Shoulder and Elbow Surgery

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Editorial Commentary: Platelet-Rich Plasma in the Treatment of Rotator Cuff Tears—From Hero to Zero?

Cited by 4 publications

References 7 publications

Efficacy of Platelet-Rich Plasma Injection in the Management of Rotator Cuff Tendinopathy: A Review of the Current Literature

Efficacy of Platelet-Rich Plasma Injection in the Management of Rotator Cuff Tendinopathy: A Review of the Current Literature

Effect of Bone Marrow Stimulation on Arthroscopic Rotator Cuff Repair: A Systematic Review and Meta-analysis

Functional and radiologic results of the crimson duvet procedure in rotator cuff treatment: a randomized controlled clinical trial

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