Liu B, Jeong HJ, Yeo JH, Oh JH. Efficacy of Intraoperative Platelet-Rich Plasma Augmentation and Postoperative Platelet-Rich Plasma Booster Injection for Rotator Cuff Healing: A Randomized Controlled Clinical Trial.
Orthop J Sports Med 2021;
9:23259671211006100. [PMID:
34159208 PMCID:
PMC8182201 DOI:
10.1177/23259671211006100]
[Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/05/2021] [Indexed: 01/08/2023] Open
Abstract
Background:
Platelet-rich plasma (PRP) has been applied as an adjuvant treatment for
arthroscopic rotator cuff repair (ARCR) to enhance rotator cuff healing.
However, it remains debatable whether PRP enhances tendon-to-bone
healing.
Purpose:
To assess the efficacy of intraoperative augmentation and postoperative
injection of PRP that was prepared using the double-spin method and calcium
activation without thrombin in patients with ARCR.
Study Design:
Randomized controlled trial; Level of evidence, 1; and cohort study; Level of
evidence, 3.
Methods:
A total of 58 patients underwent ARCR using intraoperative PRP augmentation.
Half of the patients were randomly assigned to receive an additional
ultrasound-guided PRP injection at the repair site at 2 weeks
postoperatively (PRP-booster group); the other half did not receive the
booster injection (PRP-only group). A control group that did not receive any
PRP treatment was retrospectively matched using propensity score matching.
Structural integrity was assessed using magnetic resonance imaging at 1 year
postoperatively, and healing rates were compared between patients with tear
sizes ≤2 cm versus >2 cm. Functional outcomes were assessed using the
visual analog scale (VAS) for pain; VAS for satisfaction; shoulder range of
motion; and Constant, American Shoulder and Elbow Surgeons, and Simple
Shoulder Test scores at minimum 2-year follow-up.
Results:
In patients with tears >2 cm, the rate of healing failure at 1-year
follow-up was significantly less in the overall PRP group than in the
control group (12.9% vs 35.7%, respectively; P = .040),
however, the PRP-booster group did not present a better healing rate than
did the PRP-only group. The overall PRP group had lower VAS for pain scores
compared with the control group (0.5 ± 1.1 vs 1.3 ± 1.8, respectively;
P = .016) and higher VAS for satisfaction scores (9.2 ±
1.2 vs 8.6 ± 1.7; P = .023) at the final follow-up, whereas
no statistical difference was found between the PRP-only and PRP-booster
groups in functional outcomes.
Conclusion:
Intraoperative PRP augmentation during ARCR demonstrated superior anatomic
healing results in patients with rotator cuff tears >2 cm as well as
reduced pain and increased subjective satisfaction. PRP booster injection
provided no additional benefit to tendon integrity or functional
recovery.
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