title: Increased vascularization during early healing after biologic augmentation in repair of chronic rotator cuff tears using autologous leukocyte- and platelet-rich fibrin (L-PRF): a prospective randomized controlled pilot trial.
abstract: OBJECTIVE
  We hypothesized that arthroscopic rotator cuff repairs using leukocyte- and platelet-rich fibrin (L-PRF) in a standardized, modified protocol is technically feasible and results in a higher vascularization response and watertight healing rate during early healing.
  
  
  METHODS
  Twenty patients with chronic rotator cuff tears were randomly assigned to 2 treatment groups. In the test group (N = 10), L-PRF was added in between the tendon and the bone during arthroscopic rotator cuff repair. The second group served as control (N = 10). They received the same arthroscopic treatment without the use of L-PRF. We used a double-row tension band technique. Clinical examinations including subjective shoulder value, visual analog scale, Constant, and Simple Shoulder Test scores and measurement of the vascularization with power Doppler ultrasonography were made at 6 and 12 weeks.
  
  
  RESULTS
  There have been no postoperative complications. At 6 and 12 weeks, there was no significant difference in the clinical scores between the test and the control groups. The mean vascularization index of the surgical tendon-to-bone insertions was always significantly higher in the L-PRF group than in the contralateral healthy shoulders at 6 and 12 weeks (P = .0001). Whereas the L-PRF group showed a higher vascularization compared with the control group at 6 weeks (P = .001), there was no difference after 12 weeks of follow-up (P = .889). Watertight healing was obtained in 89% of the repaired cuffs.
  
  
  CONCLUSIONS
  Arthroscopic rotator cuff repair with the application of L-PRF is technically feasible and yields higher early vascularization. Increased vascularization may potentially predispose to an increased and earlier cellular response and an increased healing rate.
authors: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors: Matthias A
authors: MA
authors: Zumstein
authors: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors: Adam
authors: A
authors: Rumian
authors: Department of Radiology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors: Virginie
authors: V
authors: Lesbats
authors: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors: Michael
authors: M
authors: Schaer
authors: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France. Electronic address: boileau.p@chu-nice.fr.
authors: Pascal
authors: P
authors: Boileau
mesh_terms: D000368:Aged; D001182:Arthroscopy; D001792:Blood Platelets; D001804:Blood Transfusion, Autologous; D002908:Chronic Disease; D005260:Female; D005337:Fibrin / Q000627:therapeutic use*; D006801:Humans; D017708:Leukocyte Transfusion; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000502:physiology*; D010865:Pilot Projects; D011446:Prospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D000070636:Rotator Cuff Injuries; D016896:Treatment Outcome; D014463:Ultrasonography; D014945:Wound Healing / Q000502:physiology*
chemical_list: D005337:Fibrin
keywords: Level I; Randomized Controlled Trial; Shoulder arthroscopy; Treatment Study; leukocyte- and platelet-rich fibrin (L-PRF); rotator cuff; vascularization