Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis

Gwinner, Clemens; Gerhardt, Christian; Haneveld, Hendrik; Scheibel, Markus

doi:10.1007/s00402-016-2499-4

Cited by 28 publications

(22 citation statements)

References 30 publications

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“…16,33,69 However, other published studies often employed a single (or multiple) PRP injection at, or into, the repair site at the time of surgery. †† Gwinner et al 37 employed multiple PRP injections at the repair site as well as into the subacromial bursa at the time of surgery, with a second injection at 7 days after surgery into the subacromial bursa. Hak et al 38 injected into the tendon intraoperatively in several positions along the repair site as well as into the subacromial bursa, with a second series of injections at the tendon-bone interface and into the subacromial bursa at 4 weeks after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The postoperative improvement observed in the QuickDASH and OSS in this study appears consistent with the existing literature evaluating outcomes after rotator cuff repair in combination with PRP. 25 However, it must be acknowledged that a range of other PROMs have been employed in these studies, including the American Shoulder and Elbow Surgeons (ASES) questionnaire, 3,25,41,43,52,55 the Simple Shoulder Test (SST), 3,12,34,43,44,53,67,68 the subjective shoulder value (SSV), 37 the University of California, Los Angeles (UCLA) score, 12,43,44,49,52,53,56,67 the Shoulder Pain and Disability Index (SPADI), 43,44 the Western Ontario Rotator Cuff Index (WORC), 37,41 and the L'Insalata shoulder score. 55 The use of different PROMs makes a direct comparison difficult.…”

Section: Discussionmentioning

confidence: 99%

“…8,57,63 To date, clinical studies on PRP and rotator cuff repair have generally reported short-term outcomes. Apart from one study that followed patients to a mean of 31 months 3 and several following patients to 24 months, 2,12,25,37,49,52,53 the remaining studies only reported a short-term follow-up of ≤12 months **. Should a benefit exist in creating a more robust repair and therefore creating a tendon that is more resistant to future reinjuries, then randomized controlled trials (RCTs) with a longer term follow-up are essential to evaluate the full potential benefit of PRP.…”

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confidence: 99%

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A Midterm Evaluation of Postoperative Platelet-Rich Plasma Injections on Arthroscopic Supraspinatus Repair: A Randomized Controlled Trial

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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A Midterm Evaluation of Postoperative Platelet-Rich Plasma Injections on Arthroscopic Supraspinatus Repair: A Randomized Controlled Trial

et al. 2017

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“…Some studies suggested a pain reduction following PRP application [ 16 , 44 ]. However, recent reviews and meta-analyses found no significant effects of PRP augmentation in the treatment of full thickness RC tear repairs by means of outcome scores or re-tear rates [ 5 , 7 , 21 , 30 , 47 , 51 , 60 , 63 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of autologous platelet rich plasma on tenocytes of the human rotator cuff

Pauly

Klatte‐Schulz

Stahnke

et al. 2018

BMC Musculoskelet Disord

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BackgroundPlatelet rich plasma (PRP) is widely used in rotator cuff repairs but its effect on the healing process is unclear. Several cell culture studies on the effect of allogenic PRP have reported promising results but are not transferable to clinical practice.The aim of the present study is to assess the possible effect of autologous PRP on rotator cuff tendon cells. The amount of growth factors involved with tendon-bone healing (PDGF-AB, IGF-1, TGF-β1, BMP-7 and -12) is quantified.MethodsRotator cuff tissue samples were obtained from (n = 24) patients grouped by age (>/< 65 years) and sex into four groups and cells were isolated and characterized. Later, autologous PRP preparations were obtained and the effect was analyzed by means of cell proliferation, collagen I synthesis and expression of collagen I and III. Furthermore, the PRPs were quantified for growth factor content by means of platelet-derived growth factor (PDGF-AB), insulin-like growth factor (IGF-1), transforming growth factor (TGF-β1), as well as bone morphogenetic protein (BMP) -7 and − 12.ResultsCell proliferation and absolute synthesis of collagen I were positively affected by PRP exposure compared to controls (p < 0.05), but expression and relative synthesis of collagen I (normalized to cell proliferation) were significantly reduced.PRP contained high amounts of IGF-1 and lower levels of TGF-β1 and PDGF-AB. The amounts of BMP-7 and -12 were below the detection limits.ConclusionsPRP is a source of growth factors such involved with tendon-bone healing. PRP had an anabolic effect on the human rotator cuff tenocytes of the same individual in vitro by means of cell proliferation and absolute, but not relative collagen I synthesis.These results encourage further studies on clinical outcomes with more comparable standards in terms of preparation and application methods.Level of evidenceControlled laboratory study.

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“…As well as, there are new technologies are used in PRP preparation by using ACP system (autologous conditioned plasma) [33], AutoloGel™ system for PRP diabetic ulcer treatment and commercially available kits [34]. Although these methods are recently available techniques; the classical centrifugal method was described as low cost preparation method, most accurate and rational choice for manual making [35,36].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of subcutaneous infiltration of autologous platelet-rich plasma on skin-wound healing in dogs

et al. 2017

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Platelet-rich plasma (PRP) is known to be rich in growth factors and cytokines, which are crucial to the healing process. This study investigate the effect of subcutaneous (S/C) infiltration of autologous PRP at the wound boundaries on wound epithelization and contraction. Five adult male mongrel dogs were used. Bilateral acute full thickness skin wounds (3 cm diameter) were created on the thorax symmetrically. Right side wounds were subcutaneously infiltrated with activated PRP at day 0 and then every week for three consecutive weeks. The left wound was left as control. Wound contraction and epithelization were clinically evaluated. Expression of collagen type I (COLI) A2, (COLIA2),histopathology and immunohistochemical (IHC) staining of COLI α1 (COLIA1) were performed on skin biopsies at first, second and third weeks. The catalase activity, malondialdehyde (MDA) concentration and matrix metalloproteinase (MMP) 9 (MMP-9) activity were assessed in wound fluid samples. All data were analysed statistically. The epithelization percent significantly increased in the PRP-treated wound at week 3. Collagen was well organized in the PRP-treated wounds compared with control wounds at week 3. The COLIA2 expression and intensity of COLIA1 significantly increased in PRP-treated wounds. MDA concentration was significantly decreased in PRP-treated wound at week 3. The catalase activity exhibited no difference between PRP treated and untreated wounds. The activity of MMP-9 reached its peak at the second week and was significantly high in the PRP-treated group. S/C infiltration of autologous PRP at the wound margins enhances the wound epithelization and reduces the scar tissue formation.

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Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis

Abstract: Level III, Retrospective comparative study.

Cited by 28 publications

References 30 publications

A Midterm Evaluation of Postoperative Platelet-Rich Plasma Injections on Arthroscopic Supraspinatus Repair: A Randomized Controlled Trial

A Midterm Evaluation of Postoperative Platelet-Rich Plasma Injections on Arthroscopic Supraspinatus Repair: A Randomized Controlled Trial

The effect of autologous platelet rich plasma on tenocytes of the human rotator cuff

Evaluation of subcutaneous infiltration of autologous platelet-rich plasma on skin-wound healing in dogs

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