Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials

Abstract

Background Recently, many authors have reported the effects of platelet-rich plasma (PRP) on rotator cuff repair. Whether PRP treatment during arthroscopic rotator cuff repair improves tendon healing rates or restores full function remains unknown. The purpose of this meta-analysis was to evaluate the clinical improvement and radiological outcomes of PRP treatment in patients undergoing arthroscopic rotator cuff repair. Methods PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched. The study included only level 1 or 2 randomized controlled trials (RCTs) that compared the injection of platelet-rich plasma or platelet-rich fibrin matrix. The methodological quality of the trials was assessed using the Cochrane Handbook for Systematic Reviews of Interventions, 5.3. Continuous variables were analysed using the weighted mean difference, and categorical variables were assessed using relative risks. P < 0.05 was considered statistically significant. Results The meta-analysis revealed a lower retear rate following PRP treatment than that following the control method (mean difference, 1.10; 95% CI, 1.03 to 1.18; P = 0.004). Constant shoulder scores improved with PRP (mean difference, 2.31; 95% CI, 1.02 to 3.61; P = 0.0005). PRP treatment also resulted in higher UCLA scores (mean difference, 0.98; 95% CI, 0.27 to 1.69; P = 0.007), and simple shoulder test scores were improved (mean difference, 0.43; 95% CI, 0.11 to 0.75; P = 0.008). Finally, lower visual analogue scale scores were observed with PRP augmentation (mean difference, − 0.35; 95% CI, − 0.57 to − 0.13; P = 0.002). Conclusions The current systematic review and meta-analysis reveals that PRP treatment with arthroscopic repair of rotator cuff tears decreases the retear rate and improves the clinical outcomes. Systematic review registration PROSPERO CRD42016048416

Safety and efficacy of treating symptomatic, partial-thickness rotator cuff tears with fresh, uncultured, unmodified, autologous adipose-derived regenerative cells (UA-ADRCs) isolated at the point of care: a prospective, randomized, controlled first-in-human pilot study

“…Many studies tested treatment of rotator cuff injuries and sPTRCT with PRP (see [25,26,[61][62][63][64][65][66][67] for the most recent systematic reviews, meta-analyses, and editorial comments in this regard). Earlier systematic reviews and meta-analyses showed no (or almost no) benefit of augmenting arthroscopic rotator cuff repair with PRP [61][62][63][64], but two very recent meta-analyses demonstrated that the use of PRP in rotator cuff repair resulted in improved functional outcomes, pain levels, and healing rates compared to control [65,66].…”

Safety and Efficacy of Treating Symptomatic, Partial-Thickness Rotator Cuff Tear with Fresh, Uncultured, Unmodified, Autologous Adipose Derived Regenerative Cells (UA-ADRCs) Isolated at Point of Care: A Prospective, Randomized, Controlled First-in-Human Pilot Study

“…Many studies tested treatment of rotator cuff injuries and sPTRCT with platelet rich plasma (PRP) (see [50][51][52][53][54][55][56][57] for the most recent systematic reviews, meta-analyses and editorial comments in this regard). Whereas earlier systematic reviews and meta-analyses showed no (or almost no) benefit of augmenting arthroscopic rotator cuff repair with PRP [50][51][52][53], two very recent meta-analyses demonstrated that the use of PRP in rotator cuff repair resulted in improved functional outcomes, pain levels and healing rates compared to control [54,55].…”

A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro

“…As a concentrated source of autologous platelets, PRP releases several different growth factors and other cytokines through degranulation that promote healing of bone and soft tissue. PRP biological effects depend on the activation of α-granules in platelet resulting in release of various high concentrative growth factors and depends on the reticulate fibrous cross-linking structure from fibrinogen [2]. Formed reticulate fibrous scaffold can support new tissues regeneration with various growth factors induction.…”