The role of platelet-rich plasma in arthroscopic rotator cuff repair: a systematic review with quantitative synthesis.
OBJECTIVE
Despite the theoretic basis and interest in using platelet-rich plasma (PRP) to improve the potential for rotator cuff healing, there remains ongoing controversy regarding its clinical efficacy. The objective of this systematic review was to identify and summarize the available evidence to compare the efficacy of arthroscopic rotator cuff repair in patients with full-thickness rotator cuff tears who were concomitantly treated with PRP.


METHODS
We searched the Cochrane Central Register of Controlled Trials, Medline, Embase, and PubMed for eligible studies. Two reviewers selected studies for inclusion, assessed methodologic quality, and extracted data. Pooled analyses were performed using a random effects model to arrive at summary estimates of treatment effect with associated 95% confidence intervals.


RESULTS
Five studies (2 randomized and 3 nonrandomized with comparative control groups) met the inclusion criteria, with a total of 261 patients. Methodologic quality was uniformly sound as assessed by the Detsky scale and Newcastle-Ottawa Scale. Quantitative synthesis of all 5 studies showed that there was no statistically significant difference in the overall rate of rotator cuff retear between patients treated with PRP and those treated without PRP (risk ratio, 0.77; 95% confidence interval, 0.48 to 1.23). There were also no differences in the pooled Constant score; Simple Shoulder Test score; American Shoulder and Elbow Surgeons score; University of California, Los Angeles shoulder score; or Single Assessment Numeric Evaluation score.


CONCLUSIONS
PRP does not have an effect on overall retear rates or shoulder-specific outcomes after arthroscopic rotator cuff repair. Additional well-designed randomized trials are needed to corroborate these findings.


METHODS
Level III, systematic review of Level I, II, and III studies.
Division of Sports Medicine, Rush University Medical Center, Chicago, Illinois, USA. jaschahal@hotmail.com
Jaskarndip
J
Chahal
Geoffrey S
GS
Van Thiel
Nathan
N
Mall
Wendell
W
Heard
Bernard R
BR
Bach
Brian J
BJ
Cole
Gregory P
GP
Nicholson
Nikhil N
NN
Verma
Daniel B
DB
Whelan
Anthony A
AA
Romeo
D001182:Arthroscopy; D005500:Follow-Up Studies; D006801:Humans; D022125:Lacerations / Q000628:therapy*; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D055502:Secondary Prevention; D012782:Shoulder / Q000601:surgery*; D000070599:Shoulder Injuries; D013708:Tendon Injuries / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing