title: Does platelet-rich plasma accelerate recovery after rotator cuff repair? A prospective cohort study.
abstract: BACKGROUND
  Platelet-rich plasma (PRP) has been recently used to enhance and accelerate the healing of musculoskeletal injuries and diseases, but evidence is still lacking, especially on its effects after rotator cuff repair.
  
  
  OBJECTIVE
  Platelet-rich plasma accelerates recovery after arthroscopic rotator cuff repair in pain relief, functional outcome, overall satisfaction, and enhanced structural integrity of repaired tendon.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  Forty-two patients with full-thickness rotator cuff tears were included. Patients were informed about the use of PRP before surgery and decided themselves whether to have PRP placed at the time of surgery. Nineteen patients underwent arthroscopic rotator cuff repair with PRP and 23 without. Platelet-rich plasma was prepared via plateletpheresis and applied in the form of a gel threaded to a suture and placed at the interface between tendon and bone. Outcomes were assessed preoperatively and at 3, 6, 12, and finally at a minimum of 16 months after surgery (at an average of 19.7 ± 1.9 months) with respect to pain, range of motion, strength, and overall satisfaction, and with respect to functional scores as determined using the following scoring systems: the American Shoulder and Elbow Surgeon (ASES) system, the Constant system, the University of California at Los Angeles (UCLA) system, the Disabilities of the Arm, Shoulder and Hand (DASH) system, the Simple Shoulder Test (SST) system, and the Shoulder Pain and Disability Index (SPADI) system. At a minimum of 9 months after surgery, repaired tendon structural integrities were assessed by magnetic resonance imaging.
  
  
  RESULTS
  Platelet-rich plasma gel application to arthroscopic rotator cuff repairs did not accelerate recovery with respect to pain, range of motion, strength, functional scores, or overall satisfaction as compared with conventional repair at any time point. Whereas magnetic resonance imaging demonstrated a retear rate of 26.7% in the PRP group and 41.2% in the conventional group, there was no statistical significance between the groups (P = .388).
  
  
  CONCLUSIONS
  The results suggest that PRP application during arthroscopic rotator cuff repair did not clearly demonstrate accelerated recovery clinically or anatomically except for an improvement in internal rotation. Nevertheless, as the study may have been underpowered to detect clinically important differences in the structural integrity, additional investigations, including the optimization of PRP preparation and a larger randomized study powered for healing rate, are necessary to further determine the effect of PRP.
authors: Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. chrisjo@snu.ac.kr
authors: Chris Hyunchul
authors: CH
authors: Jo
authors: Ji Eun
authors: JE
authors: Kim
authors: Kang Sup
authors: KS
authors: Yoon
authors: Ji Ho
authors: JH
authors: Lee
authors: Seung Baik
authors: SB
authors: Kang
authors: Jae Hyup
authors: JH
authors: Lee
authors: Hyuk Soo
authors: HS
authors: Han
authors: Seung Hwan
authors: SH
authors: Rhee
authors: Sue
authors: S
authors: Shin
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D017060:Patient Satisfaction; D053657:Platelet-Rich Plasma; D016059:Range of Motion, Articular / Q000502:physiology; D017006:Rotator Cuff / Q000502:physiology* / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D020069:Shoulder Pain / Q000503:physiopathology / Q000601:surgery; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing