Platelet-Rich Plasma for Arthroscopic Repair of Medium to Large Rotator Cuff Tears

Jo, Chris Hyunchul; Shin, Ji Sun; Shin, Won Hyoung; Lee, Seung Yeon; Yoon, Kang Sup; Shin, Sue

doi:10.1177/0363546515587081

Cited by 143 publications

(181 citation statements)

References 46 publications

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“…and thirteen provided the leukocyte concentration of the PRP used. The platelet concentration ranged from 1.7 to 8 times the baseline concentration, with a median value of 3.5 times the baseline concentration 4,21,22,26,[29][30][31] . Of the four studies in which the platelet concentration was #3.5, only one showed improved radiographic outcomes in association with PRP treatment.…”

Section: Discussionmentioning

confidence: 99%

“…We identified seventeen studies investigating the use of PRP as an adjunct for surgical repair of rotator cuff tears [2][3][4][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , including thirteen randomized controlled trials (RCTs); one prospective cohort study; two casecontrol studies; and one cohort study involving a retrospective control group. The number of patients ranged from twenty to eighty-eight.…”

Section: Rotator Cuff Tearsmentioning

confidence: 99%

“…All patients were managed with arthroscopic rotator cuff repair; the studies varied as to whether concomitant procedures such as acromioplasty and/or biceps tenodesis were always performed, were performed if indicated, or resulted in exclusion of patients from the study. The most common outcome measures were (1) magnetic resonance imaging (MRI) assessment for the evaluation of retears and (2) clinical outcome scores, most commonly visual analog scale (VAS) scores [2][3][4]19,21,22,27,29,30,32 , the Disabilities of the Arm, Shoulder and Hand (DASH) score 3,21,22,30,32 , and the University of California at Los Angeles (UCLA) shoulder-rating scale 4,[19][20][21][22]24,27,31 .…”

Section: Rotator Cuff Tearsmentioning

confidence: 99%

“…Of the fourteen studies that assessed the integrity of the cuff repair at least six months postoperatively, four demonstrated that PRP treatment was associated with lower rates of retear 21,23,26,29 , ten demonstrated no difference 3,4,19,22,24,25,27,28,30,31 , and one demonstrated that PRP treatment was associated with a higher rate of retear 20 . Charousset et al reported that, although they found no significant difference in terms of failure rates, the retears tended to be smaller in the PRP group 24 .…”

Section: Rotator Cuff Tearsmentioning

confidence: 99%

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Biological Treatments for Tendon and Ligament Abnormalities

et al. 2016

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The poor intrinsic healing potential of tendon and ligamentous tissue has driven the search for biological agents that can improve healing, most notably platelet-rich plasma (PRP) and autologous stem cells. Current evidence best supports the use of PRP as treatment for chronic, degenerative tendinopathies such as lateral epicondylitis of the elbow or patellar tendinopathy. It does not support the use of PRP to promote tendon or ligament-to-bone healing in rotator cuff repair or anterior cruciate ligament (ACL) reconstruction. Clinical evidence regarding the use of autologous stem cells as treatment for tendon and ligament abnormalities is currently limited. However, the initial results appear to be promising, particularly following rotator cuff repair. A major limitation in the evaluation of current data is the lack of standardization in the preparation and composition of PRP, which are often not reported. Future investigators should make an effort to report the method of preparation and final composition of PRP used. Autologous stem cells were most often harvested from bone marrow aspirate but were occasionally derived from dermal tenocyte cells. Recent studies have explored new sources for stem cells, including adipose tissue, peripheral blood, and human amniotic tissue. We expect that clinical data evaluating these treatments will soon emerge.

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Section: Discussionmentioning

confidence: 99%

Section: Rotator Cuff Tearsmentioning

confidence: 99%

Section: Rotator Cuff Tearsmentioning

confidence: 99%

Section: Rotator Cuff Tearsmentioning

confidence: 99%

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Biological Treatments for Tendon and Ligament Abnormalities

et al. 2016

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“…Several other trials also found no significant differences in perioperative morbidity, clinical outcomes, or structural integrity when aPRP gel application was compared to a no-intervention cohort [34][35][36]. One group published two randomized trials comparing medium and large rotator cuff tears repaired with or without the addition of aPRP [37,38]. The trials included 48 and 74 patients, and shared similar trial designs, but differed slightly in their outcome measures.…”

Section: Orthopedicsmentioning

confidence: 99%

Autologous platelet-rich plasma

Cohn

Lockhart

2015

Current Opinion in Hematology

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Efficacy of platelet‐rich plasma and platelet‐rich fibrin in arthroscopic rotator cuff repair: A systematic review and meta‐analysis

Peng

Li²,

Yang

et al. 2023

PM&R

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ObjectiveBasic scientific studies have demonstrated positive effects of platelet‐rich therapies, such as platelet‐rich plasma (PRP) and platelet‐rich fibrin (PRF), on tendon repair. However, clinical evidence indicating improved prognosis is controversial. In this study, we aimed to determine whether augmentation of arthroscopic rotator cuff repair with PRP and PRF improves outcomes compared to arthroscopic repair alone.Literature SurveyPubMed, Embase and Cochrane library databases were comprehensively searched for randomized controlled trials (RCTs) published until June 2022 according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. No language restriction was applied.MethodologyThe primary outcomes were the rate of repeat tears after arthroscopic rotator cuff repair (retear rate) and clinical function scores (Constant‐Murley score, University of California, Los Angeles score), and the extracted data were assessed for quality. Statistical analyses were performed using Review manager 5.3, and P < 0.05 was considered statistically significant.SynthesisTen RCTs with 628 patients were included. The results showed that augmenting surgery with PRP reduces retear rates compared to surgery alone (risk ratio [RR] = 0.40, 95% confidence interval [CI] [0.23, 0.69], P = 0.001), whereas PRF has no effect on retear rates (P = 0.92). Regarding clinical function, PRP improves constant scores (mean difference [MD] = 2.03, 95% CI [0.13, 3.93], P = 0.04) and University of California, Los Angeles scores (MD = 1.30, 95% CI [0.36, 2.24], P = 0.007), whereas PRF only improves constant scores (MD = 3.93, 95% CI [1.50, 6.36], P = 0.002). However, these differences were small and below the minimum clinically important difference threshold.ConclusionsThis study showed that compared to arthroscopic rotator cuff repair alone, the application of PRP in arthroscopic rotator cuff repair reduces retear rate and improves clinical function scores, whereas the application of PRF has no clinically meaningful benefit. The small number and heterogeneity of studies as well as methodological limitations and risk of bias limit confidence in the true effect.This article is protected by copyright. All rights reserved.

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Platelet-Rich Plasma for Arthroscopic Repair of Medium to Large Rotator Cuff Tears

Cited by 143 publications

References 46 publications

Biological Treatments for Tendon and Ligament Abnormalities

Biological Treatments for Tendon and Ligament Abnormalities

Autologous platelet-rich plasma

Efficacy of platelet‐rich plasma and platelet‐rich fibrin in arthroscopic rotator cuff repair: A systematic review and meta‐analysis

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