title: Does autologous leukocyte-platelet-rich plasma improve tendon healing in arthroscopic repair of large or massive rotator cuff tears?
abstract: OBJECTIVE
  To evaluate the clinical and magnetic resonance imaging (MRI) outcome of arthroscopic rotator cuff repair with the use of leukocyte-platelet-rich plasma (L-PRP) in patients with large or massive rotator cuff tears.
  
  
  METHODS
  A comparative cohort of patients with large or massive rotator cuff tears undergoing arthroscopic repair was studied. Two consecutive groups of patients were included: rotator cuff repairs with L-PRP injection (group 1, n = 35) and rotator cuff repairs without L-PRP injection (group 2, n = 35). A double-row cross-suture cuff repair was performed by a single surgeon with the same rehabilitation protocol. Patients were clinically evaluated with the Constant score; Simple Shoulder Test score; University of California, Los Angeles (UCLA) score; and strength measurements by use of a handheld dynamometer. Rotator cuff healing was evaluated by postoperative MRI using the Sugaya classification (type 1 to type 5).
  
  
  RESULTS
  We prospectively evaluated the 2 groups at a minimum 2-year follow-up. The results did not show differences in cuff healing between the 2 groups (P = .16). The size of recurrent tears (type 4 v type 5), however, was significantly smaller in group 1 (P = .008). There was no statistically significant difference in the recurrent tear rate (types 4 and 5) between the 2 groups (P = .65). There was no significant difference between group 1 and group 2 in terms of University of California, Los Angeles score (29.1 and 30.3, respectively; P = .90); Simple Shoulder Test score (9.9 and 10.2, respectively; P = .94); Constant score (77.3 and 78.1, respectively; P = .82); and strength (7.5 and 7.0, respectively; P = .51).
  
  
  CONCLUSIONS
  In our study the use of autologous L-PRP did not improve the quality of tendon healing in patients undergoing arthroscopic repair of large or massive rotator cuff tears based on postoperative MRI evaluation. The only significant advantage was that the L-PRP patients had smaller iterative tears. However, the functional outcome was similar in the 2 groups of patients.
  
  
  METHODS
  Level III, case-control study.
authors.affiliation: Institut Osteo Articulaire Paris Courcelles, Paris, France. Electronic address: dr.charousset@ioapc.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Charousset
authors.affiliation: Laboratory of Bio-engineering and Osteo-articular Biomaterial, University Denis Diderot, Paris, France.
authors.forename: Amine
authors.initials: A
authors.lastname: Zaoui
authors.affiliation: Centre d'Image Médicale Bachaumont, Paris, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bellaïche
authors.affiliation: Laboratoire Parole et Langage, CNRS, Aix-Marseille Université, Aix-en-Provence, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Piterman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017708:Leukocyte Transfusion; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D017006:Rotator Cuff / Q000503:physiopathology* / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D013708:Tendon Injuries / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D014182:Transplantation, Autologous; D014945:Wound Healing