title: SECEC Research Grant 2008 II: Use of platelet- and leucocyte-rich fibrin (L-PRF) does not affect late rotator cuff tendon healing: a prospective randomized controlled study.
abstract: BACKGROUND
  Because the retear rate after rotator cuff repairs remains high, methods to improve healing are very much needed. Platelet-rich concentrates have been shown to enhance tenocyte proliferation and promote extracellular matrix synthesis in vitro; however, their clinical benefit remains unclear. We hypothesized that arthroscopic rotator cuff repair with leucocyte- and platelet-rich fibrin (L-PRF) results in better clinical and radiographic outcome at 12 months of follow-up than without L-PRF.
  
  
  METHODS
  Thirty-five patients were randomized to receive arthroscopic rotator cuff repair with L-PRF locally applied to the repair site (L-PRF+ group, n = 17) or without L-PRF (L-PRF- group, n = 18). Preoperative and postoperative clinical evaluation included the Subjective Shoulder Value, visual analog score for pain, Simple Shoulder Test, and Constant-Murley score. The anatomic watertight healing, tendon thickness, and tendon quality was evaluated using magnetic resonance arthrography at 12 months of follow-up.
  
  
  RESULTS
  No complications were reported in either group. The mean Subjective Shoulder Value, Simple Shoulder Test, and Constant-Murley scores increased from preoperatively to postoperatively, showing no significant differences between the groups. Complete anatomic watertight healing was found in 11 of 17 in the L-PRF+ group and in 11 of 18 in the L-PRP- group (P = .73). The mean postoperative defect size (214 ± 130 mm(2) in the L-PRF+ group vs 161 ± 149 mm(2) in the L-PRF- group; P = .391) and the mean postoperative tendon quality according to Sugaya (L-PRF+ group: 3.0 ± 1.4, L-PRF- group: 3.0 ± 0.9) were similar in both groups at 12 months of follow-up.
  
  
  CONCLUSIONS
  Arthroscopic rotator cuff repair with application of L-PRF yields no beneficial effect in clinical outcome, anatomic healing rate, mean postoperative defect size, and tendon quality at 12 months of follow-up.
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Matthias A
authors.initials: MA
authors.lastname: Zumstein
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Adam
authors.initials: A
authors.lastname: Rumian
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Charles Édouard
authors.initials: CÉ
authors.lastname: Thélu
authors.affiliation: Department of Radiology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lesbats
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Kieran
authors.initials: K
authors.lastname: O'Shea
authors.affiliation: Department of Orthopaedic Surgery and Sports Traumatology, L'Archet Hospital II, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Schaer
authors.affiliation: 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.forename: Pascal
authors.initials: P
authors.lastname: Boileau
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy; D001792:Blood Platelets; D005260:Female; D005337:Fibrin / Q000627:therapeutic use; D006801:Humans; D007962:Leukocytes; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D020069:Shoulder Pain / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D005337:Fibrin
keywords: Shoulder arthroscopy; leucocyte and platelet-rich fibrin (L-PRF); platelet-rich concentrates; rotator cuff