title: Rotator cuff repair healing influenced by platelet-rich plasma construct augmentation.
abstract: OBJECTIVE
  To assess the effect of platelet-rich plasma fibrin matrix (PRPFM) construct augmentation on postoperative tendon healing as determined by magnetic resonance imaging (MRI) and clinical outcome of arthroscopic rotator cuff repair.
  
  
  METHODS
  A comparative series of patients undergoing arthroscopic rotator cuff repair was studied. Two matched groups of patients (20 each) were included: rotator cuff repairs without PRPFM augmentation (group 1) and rotator cuff repairs augmented with 2 sutured platelet-rich plasma (PRP) constructs (group 2). A single-row cuff repair to the normal footprint without tension or marrow vents was performed by a single surgeon. Postoperative rehabilitation was held constant. Postoperative MRI scans were used to evaluate rotator cuff healing. Outcome measures included American Shoulder and Elbow Surgeons, Rowe, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Constant scores.
  
  
  RESULTS
  We followed up 40 patients (2 matched groups with 20 patients each) with a mean age of 57 years (range, 44 to 69 years) for a mean of 31 months (range, 24 to 44 months). Postoperative MRI studies showed persistent full-thickness tendon defects in 60% of controls (12 of 20) and 30% of PRPFM-augmented repairs (6 of 20) (P = .03). Of the control group tears measuring less than 3 cm in anteroposterior length, 50% (7 of 14) healed fully, whereas 86% of the PRPFM group tears measuring less than 3 cm in anteroposterior length (12 of 14) healed fully (P < .05). There was no significant difference between groups 1 and 2 in terms of American Shoulder and Elbow Surgeons (94.7 and 95.7, respectively; P = .35), Single Assessment Numeric Evaluation (93.7 and 94.5, respectively; P = .37), Simple Shoulder Test (11.4 and 11.3, respectively; P = .41), and Constant (84.7 and 88.1, respectively; P = .19) scores. The Rowe scores (84.8 and 94.9, respectively; P = .03) were statistically different.
  
  
  CONCLUSIONS
  The addition of 2 PRPFM constructs sutured into a primary rotator cuff tendon repair resulted in lower retear rates identified on MRI than repairs without the constructs. Other than the Rowe scores, there was no postoperative clinical difference by use of standard outcome measures.
  
  
  METHODS
  Level III, case-control study.
authors.affiliation: Plano Orthopedic Sports Medicine and Spine Center, Plano, Texas, USA.
authors.forename: F Alan
authors.initials: FA
authors.lastname: Barber
authors.forename: Scott A
authors.initials: SA
authors.lastname: Hrnack
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Snyder
authors.forename: Onur
authors.initials: O
authors.lastname: Hapa
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D005337:Fibrin / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D017006:Rotator Cuff / Q000502:physiology* / Q000601:surgery; D000070636:Rotator Cuff Injuries; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D005337:Fibrin