title: Are platelet-rich products necessary during the arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis.
abstract: BACKGROUND
  Platelet-rich products (PRP) are widely used for rotator cuff tears. However, whether platelet-rich products produce superior clinical or radiological outcomes is controversial. This study aims to use meta-analysis to compare clinical and radiological outcomes between groups with or without platelet-rich products.
  
  
  METHODS
  The Pubmed, Embase, and Cochrane library databases were searched for relevant studies published before April 20, 2013. Studies were selected that clearly reported a comparison between the use or not of platelet-rich products. The Constant, ASES, UCLA, and SST scale systems and the rotator cuff retear rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects model.
  
  
  RESULTS
  Seven studies were enrolled in this meta-analysis. No significant differences were found for the Constant scale (0.73, 95% CI, -1.82 to 3.27, P=0.58), ASES scale (-2.89, 95% CI, -6.31 to 0.53, P=0.1), UCLA scale (-0.79, 95% CI, -2.20 to 0.63, P=0.28), SST scale (0.34, 95% CI, -0.01 to 0.69, P=0.05), and the overall rotator cuff retear rate (0.71, 95% CI, 0.48 to 1.05, P=0.08). Subgroup analysis according to the initial tear size showed a lower retear rate in small- and medium-sized tears (0.33, 95% CI, 0.12 to 0.91, P=0.03) after platelet-rich product application but no difference for large- and massive-sized tears (0.86, 95% CI, 0.60 to 1.23, P=0.42).
  
  
  CONCLUSIONS
  In conclusion, the meta-analysis suggests that the platelet-rich products have no benefits on the overall clinical outcomes and retear rate for the arthroscopic repair of full-thickness rotator cuff tears. However, a decrease occurred in the rate of retears among patients treated with PRP for small- and medium-sized rotator cuff tears but not for large- and massive-sized tears.
  
  
  METHODS
  Level II.
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.forename: Heng'an
authors.initials: H
authors.lastname: Ge
authors.forename: Jiaojiao
authors.initials: J
authors.lastname: Zhou
authors.forename: Biao
authors.initials: B
authors.lastname: Cheng
mesh_terms: D001182:Arthroscopy; D001792:Blood Platelets / Q000378:metabolism*; D006801:Humans; D017594:Publication Bias; D017006:Rotator Cuff / Q000601:surgery*; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing