Schoch BS, Werner BC, Shapiro SA, Camp CL, Chalmers PN, Cancienne JM. Effect of Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma Augmentation on the Rate of Revision Rotator Cuff Repair.
Orthop J Sports Med 2022;
10:23259671221127004. [PMID:
36353396 PMCID:
PMC9638537 DOI:
10.1177/23259671221127004]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/05/2022] [Indexed: 11/05/2022] Open
Abstract
Background:
The application of orthobiologics at the time of arthroscopic rotator cuff
repair (RCR) has received an increasing amount of clinical interest despite
a relative scarcity of human clinical studies on their efficacy.
Purpose:
To utilize a national administrative database to determine the association of
bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP)
applied at the time of RCR with revision surgery rates.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
The Mariner data set from the PearlDiver patient records repository was
utilized to identify patients undergoing RCR using Current Procedural
Terminology (CPT) code 29827. Patients receiving BMAC or PRP at the time of
RCR were then identified using CPT coding. For comparison purposes, a
matched cohort was created consisting of patients who underwent RCR without
biologic augmentation in a 5:1 fashion for each biologic separately. Cases
were matched according to age, sex, tobacco use, biceps tenodesis, distal
clavicle excision, and subacromial decompression. All groups were then
queried for revision RCR or conversion to reverse shoulder arthroplasty.
Revision rates were compared utilizing a multivariate binomial logistic
regression analysis. Adjusted odds ratios (ORs) and 95% CIs were
calculated.
Results:
A total of 760 patients who underwent biologic augmentation during RCR were
identified, including 646 patients in the PRP group and 114 patients in the
BMAC group. They were compared with 3800 matched controls without documented
biologic application at the time of surgery. Compared with matched controls,
patients who received BMAC at the time of surgery experienced a
significantly lower incidence of revision surgery at 2 years (OR, 0.36; 95%
CI, 0.15-0.82; P = .015). There was no significant
difference in revision rates between PRP and matched controls (OR, 0.87; 95%
CI, 0.62-1.23; P = .183).
Conclusion:
The application of BMAC at the time of RCR was associated with a significant
decrease in the incidence of revision surgery. There was no apparent effect
of PRP on the incidence of revision surgery after primary RCR. Higher-level
clinical studies considering surgical factors are needed to more clearly
define the role of biologic adjuvants in RCR.
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