Platelet-Rich Plasma in Rotator Cuff Repair A Prospective Randomized Study

• Published in: The American journal of sports medicine Vol. 42; no. 10; pp. 2446 - 2454
• Main Authors: Malavolta, Eduardo Angeli, Gracitelli, Mauro Emilio Conforto, Ferreira Neto, Arnaldo Amado, Assunção, Jorge Henrique, Bordalo-Rodrigues, Marcelo, de Camargo, Olavo Pires
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-10-2014; Sage Publications Ltd
• Subjects: Arthroscopy; Blood platelets; Clinical trials; Double-Blind Method; Female; Humans; Injections, Intra-Articular; Magnetic Resonance Imaging; Male; Middle Aged; NMR; Nuclear magnetic resonance; Plasma; Platelet-Rich Plasma; Prospective Studies; Recurrence; Rotator cuff; Rotator Cuff - pathology; Rotator Cuff - surgery; Rotator Cuff Injuries; Shoulder; Shoulder Joint; Sports injuries; Sports medicine; Surgery; Suture Anchors; Thrombin - administration & dosage; Visual Analog Scale; arthroscopic surgery; platelet-rich plasma; rotator cuff repair
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546514541777

Background:
Although platelet-rich plasma (PRP) has been used in rotator cuff repair, most authors have been unable to report the advantages of this method in clinical trials.
Hypothesis:
The use of PRP promotes better functional and structural results in arthroscopic rotator cuff repair.
Study Design:
Randomized controlled trial; Level of evidence, 1.
Methods:
This was a prospective, randomized, double-blind study with 2 groups of 27 patients each (PRP group and control group). Complete supraspinatus tears with retraction of less than 3 cm were subjected to arthroscopic single-row repair; at the end of the surgical procedure, liquid PRP prepared by apheresis was given to the patients in the PRP group with autologous thrombin. The outcomes were assessed by the University of California at Los Angeles (UCLA) and Constant scales, visual analog scale (VAS) for pain, and magnetic resonance imaging (MRI) before and 3, 6, 12, and 24 months after surgery. The significance level was 5%.
Results:
The 2 groups of patients exhibited significant clinical improvement (P < .001). Between the preoperative assessment and 24-month follow-up, the mean UCLA score increased from 13.63 ± 3.639 to 32.70 ± 3.635 and from 13.93 ± 4.649 to 32.44 ± 4.318 in the control and PRP groups, respectively (P = .916). The mean Constant score increased from 47.37 ± 11.088 to 85.15 ± 9.879 in the control group and from 46.96 ± 11.937 to 84.78 ± 14.048 in the PRP group (P = .498). The mean VAS score varied from 7.00 ± 1.939 and 6.67 ± 1.617 before surgery to 1.15 ± 1.916 and 0.96 ± 2.244 at the 24-month assessment in the control and PRP groups, respectively (P = .418). The only difference was in the mean UCLA score at 12 months, with 30.04 ± 4.528 in the control group and 32.30 ± 3.506 in the PRP group (P = .046). The control group exhibited 1 case of a complete retear and 4 partial retears, and the PRP group exhibited 2 cases of partial retears (P = .42).
Conclusion:
Platelet-rich plasma prepared by apheresis and applied in the liquid state with thrombin did not promote better clinical results at 24-month follow-up. Given the numbers available for analysis, the retear rate also did not change.