The Effect of PRP Augmentation of Arthroscopic Repairs of Shoulder Rotator Cuff Tears on Postoperative Clinical Scores and Retear Rates: A Systematic Review and Meta-Analysis

Abstract

The aim of this review and meta-analysis is to assess recent clinical trials concerning the combination of operative treatment of rotator cuff tears and the administration of PRP and its effect on clinical scores and postoperative retear rates. The trials were used to compare the combination of PRP treatment and arthroscopic rotator cuff repair to arthroscopy alone. Twenty-five clinical trials were reviewed. A risk-of-bias assessment was made for all randomized clinical trials included, using the Cochrane collaboration’s tool as well as a quality assessment for all non-randomized studies utilizing the Newcastle–Ottawa scale. The PRP-treated patients showed statistically significant improvement postoperatively compared to control groups concerning the Constant–Murley (mean difference 2.46, 95% CI 1.4–3.52, p < 0.00001), SST (mean difference 0.32, 95% CI 0.02–0.63, p = 0.04), and UCLA (mean difference 0.82, 95% CI 0.23–1.43, p = 0.07) scores. A statistically significant decrease of retear rates in the PRP-treated patients, with a risk ratio of 0.78 (95% CI 0.65–0.94, p = 0.01), was found. We believe that the results presented have positive aspects, especially concerning the retear risk, but are yet inconclusive concerning clinical results such as shoulder pain and function.

Nanofibrous scaffolds for the healing of the fibrocartilaginous enthesis: advances and prospects

“…Strategies such as growth factors, exosomes, and even gene therapy have also been applied to promote fibrocartilaginous enthesis healing. [73][74][75] However, these therapies also have the limitation of having to be combined with biomaterials to control their release, the relatively small number of studies that make their application difficult in clinical practice, and the need to confirm their biosafety. 7,54 In short, these therapies can improve the healing of the fibrocartilaginous enthesis in some ways, but there are still limitations that need to be addressed.…”

Biomodulating healing after arthroscopic rotator cuff repair: the protocol of a randomised proof of concept trial (BIOHACK)

“…Over the last decades, there has been increasing interest in biological stimulation or bioaugmentation in order to improve tendon-to-bone healing, which has led to the development of biological implantable devices and regenerative supplements like stem cells, PRP and other growth factors 14 15. Consistent with most preclinical studies on the effect of biologicals on tendon healing, the latest meta-analyses on the effect of Platelet Rich Plasma (PRP) seem to suggest increased tendon healing after surgical repair 16–18. However, no benefits were documented in terms of clinical outcomes.…”

“…14 15 Consistent with most preclinical studies on the effect of biologicals on tendon healing, the latest meta-analyses on the effect of Platelet Rich Plasma (PRP) seem to suggest increased tendon healing after surgical repair. [16][17][18] However, no benefits were documented in terms of clinical outcomes. These inconsistent results, the high heterogeneity of injected products and generally high production and therefore usage costs of biologicals, contribute to the current lack of consensus on the ideal composition of biologicals.…”