Platelet-rich plasma for arthroscopic repair of large to massive rotator cuff tears: a randomized, single-blind, parallel-group trial.
BACKGROUND
Platelet-rich plasma (PRP) is expected to have a biological augmentation potential in the healing of various diseases and injuries, including rotator cuff tears. However, few evaluations have been performed specifically for large to massive tears.


OBJECTIVE
To assess the efficacy of PRP augmentation in patients undergoing arthroscopic repair for large to massive rotator cuff tears.


METHODS
Randomized controlled trial; Level of evidence, 1.


METHODS
A total of 48 patients scheduled for arthroscopic repair of large to massive rotator cuff tears were randomly assigned to receive either PRP-augmented (PRP group) or conventional treatment (conventional group). In the PRP group, 3 PRP gels (3 × 3 mL) were applied to each patient between the torn end and the greater tuberosity. The primary outcome measure was the retear rate assessed by magnetic resonance imaging (MRI) or computed tomographic arthrography (CTA) at a minimum of 9 months after surgery. Secondary outcome measures included pain, range of motion, muscle strength, overall satisfaction, functional scores, and the change in cross-sectional area (CSA) of the supraspinatus.


RESULTS
The retear rate of the PRP group (20.0%) was significantly lower than that of the conventional group (55.6%) (P = .023). Clinical outcomes showed no statistical difference between the 2 groups (all P > .05) except for the overall function (P = .043). The change in 1-year postoperative and immediately postoperative CSA was significantly different between the 2 groups: -15.54 ± 94.34 mm² in the PRP group versus -85.62 ± 103.57 mm² in the conventional group (P = .047).


CONCLUSIONS
The application of PRP for large to massive rotator cuff repairs significantly improved structural outcomes, as evidenced by a decreased retear rate and increased CSA of the supraspinatus compared with repairs without PRP augmentation. While there was no significant difference in clinical outcomes except the overall shoulder function after 1-year follow-up, better structural outcomes in the PRP group might suggest improved clinical outcomes at longer term follow-up.
Chris Hyunchul Jo, Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, 156-707 Seoul, Korea. chrisjo@snu.ac.kr.
Chris Hyunchul
CH
Jo
Ji Sun
JS
Shin
Young Gil
YG
Lee
Won Hyoung
WH
Shin
Hyang
H
Kim
Seung Yeon
SY
Lee
Kang Sup
KS
Yoon
Sue
S
Shin
D000368:Aged; D001178:Arthroplasty; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D053657:Platelet-Rich Plasma; D016059:Range of Motion, Articular; D012008:Recurrence; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D020069:Shoulder Pain / Q000601:surgery; D016896:Treatment Outcome
biological augmentation; integrity; large to massive rotator cuff tear; platelet-rich plasma; retear; rotator cuff repair