title: Platelet-rich plasma in rotator cuff repair: a prospective randomized study.
abstract: BACKGROUND
  Although platelet-rich plasma (PRP) has been used in rotator cuff repair, most authors have been unable to report the advantages of this method in clinical trials.
  
  
  OBJECTIVE
  The use of PRP promotes better functional and structural results in arthroscopic rotator cuff repair.
  
  
  METHODS
  Randomized controlled trial; Level of evidence, 1.
  
  
  METHODS
  This was a prospective, randomized, double-blind study with 2 groups of 27 patients each (PRP group and control group). Complete supraspinatus tears with retraction of less than 3 cm were subjected to arthroscopic single-row repair; at the end of the surgical procedure, liquid PRP prepared by apheresis was given to the patients in the PRP group with autologous thrombin. The outcomes were assessed by the University of California at Los Angeles (UCLA) and Constant scales, visual analog scale (VAS) for pain, and magnetic resonance imaging (MRI) before and 3, 6, 12, and 24 months after surgery. The significance level was 5%.
  
  
  RESULTS
  The 2 groups of patients exhibited significant clinical improvement (P < .001). Between the preoperative assessment and 24-month follow-up, the mean UCLA score increased from 13.63 ± 3.639 to 32.70 ± 3.635 and from 13.93 ± 4.649 to 32.44 ± 4.318 in the control and PRP groups, respectively (P = .916). The mean Constant score increased from 47.37 ± 11.088 to 85.15 ± 9.879 in the control group and from 46.96 ± 11.937 to 84.78 ± 14.048 in the PRP group (P = .498). The mean VAS score varied from 7.00 ± 1.939 and 6.67 ± 1.617 before surgery to 1.15 ± 1.916 and 0.96 ± 2.244 at the 24-month assessment in the control and PRP groups, respectively (P = .418). The only difference was in the mean UCLA score at 12 months, with 30.04 ± 4.528 in the control group and 32.30 ± 3.506 in the PRP group (P = .046). The control group exhibited 1 case of a complete retear and 4 partial retears, and the PRP group exhibited 2 cases of partial retears (P = .42).
  
  
  CONCLUSIONS
  Platelet-rich plasma prepared by apheresis and applied in the liquid state with thrombin did not promote better clinical results at 24-month follow-up. Given the numbers available for analysis, the retear rate also did not change.
authors.affiliation: Shoulder and Elbow Group and Trauma Group, Institute of Orthopedics and Traumatology, Medical School, University of São Paulo, São Paulo, Brazil eduardomalavolta@hotmail.com.
authors.forename: Eduardo Angeli
authors.initials: EA
authors.lastname: Malavolta
authors.affiliation: Shoulder and Elbow Group and Trauma Group, Institute of Orthopedics and Traumatology, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Mauro Emilio Conforto
authors.initials: ME
authors.lastname: Gracitelli
authors.affiliation: Shoulder and Elbow Group and Trauma Group, Institute of Orthopedics and Traumatology, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Arnaldo Amado
authors.initials: AA
authors.lastname: Ferreira Neto
authors.affiliation: Shoulder and Elbow Group and Trauma Group, Institute of Orthopedics and Traumatology, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Jorge Henrique
authors.initials: JH
authors.lastname: Assunção
authors.affiliation: Department of Radiology, Institute of Orthopedics and Traumatology, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bordalo-Rodrigues
authors.affiliation: Institute of Orthopedics and Traumatology, Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Olavo Pires
authors.initials: OP
authors.lastname: de Camargo
mesh_terms: D001182:Arthroscopy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D012008:Recurrence; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint; D053441:Suture Anchors; D013917:Thrombin / Q000008:administration & dosage; D064232:Visual Analog Scale
chemical_list: D013917:Thrombin
keywords: arthroscopic surgery; platelet-rich plasma; rotator cuff repair