The efficacy and safety of platelet-rich fibrin for rotator cuff tears: a meta-analysis

Abstract

BackgroundThe aim of this meta-analysis was to evaluate the efficacy and safety of platelet-rich fibrin (PRF) in improving clinical outcomes in rotator cuff tears.MethodsWe searched the following databases: Pubmed, Embase, and Cochrane library databases from inception to April 2018. Studies that compared platelet-rich fibrin versus placebo for rotator cuff tears were included in this meta-analysis. Risk ratio (RR) with 95% confidence interval (CI) was pooled for discontinuous outcome, and weighted mean difference (WMD) with 95% CI was pooled for continuous outcome. Stata 12.0 was used for meta-analysis.ResultsA total of eight studies with 219 patients were finally included in this meta-analysis. Compared with the control group, PRF has a negative role in reducing the re-tear rate (RR = 1.30, 95% CI = 0.97 to 1.75; P = 0.082). Subgroup analysis of re-tear rate was consistent in all subgroup analyses (single row or double row, volume, and risk of bias). There was no significant difference between the American Shoulder and Elbow Surgeons scale, University of California at Los Angeles scale, Constant score, and side effect (P > 0.05).ConclusionIn conclusion, our meta-analysis suggests that the PRF does not have better effect on improving the overall clinical outcomes and re-tear rate in the arthroscopic repair of rotator cuff tears.

Effects of applying platelet-rich plasma during arthroscopic rotator cuff repair: a systematic review and meta-analysis of randomised controlled trials

“…Nevertheless, our review had several differences compared with previous systematic reviews and meta-analyses [15][16][17] . First, the previous reviews included studies that involved intraoperative administration and sonographyguided postoperative administration of PRP.…”

“…Recent studies have reported that PRP can potentially aid wound repair 10 , 11 , 22 . Nevertheless, the effects of PRP on rotator cuff repair remain controversial 15 – 17 . Delve into the previous studies 15 – 17 , some of these 15 , 16 stated that PRP application is effective in reducing retear rate and improving clinical outcome while the other 17 showed no improvement in both.…”

“…Nevertheless, the effects of PRP on rotator cuff repair remain controversial 15 – 17 . Delve into the previous studies 15 – 17 , some of these 15 , 16 stated that PRP application is effective in reducing retear rate and improving clinical outcome while the other 17 showed no improvement in both. Furthermore, some studies included different type of rotator cuff tear, some included PRP application both intra-operative and post-operative, and some included patients with rotator cuff tear that were not diagnosed by MRI or sonography pre-operative.…”

Plateletten zengin fibrinin iyileşme ve rejenerasyon sürecindeki rolü ve ortopedik cerrahide kullanımına dair bir derleme

“…Given the association of PRF, unlike other platelet concentrates, with progressive release of cytokines during fibrin matrix remodelling, application of growth factor mixtures through PRF maps is considered a potential approach for tendon-bone insertion regeneration such as rotator cuff repair (64). Accordingly, sutu-ring PRF side-to-side to close the tear in patients with rotator cuff tear was reported to be associated with improved range of motion and pain relief alongside the decrease in the re-tear rates (65,66).…”

Striking Differences in Platelet Distribution between Advanced-Platelet-Rich Fibrin and Concentrated Growth Factors: Effects of Silica-Containing Plastic Tubes

“…Platelet-rich fibrin (PRF) has been applied increasingly in regenerative dentistry and orthopedic surgery. PRF is derived from platelet-rich plasma and is characterized by its simple preparation protocol that does not employ anticoagulants or coagulation factors [1,2,3,4,5,6,7]. However, the reproducibility and predictability of PRF therapy remains controversial, especially in the context of bone regeneration [8].…”