title: Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis.
abstract: BACKGROUND
  Failure rates after arthroscopic rotator cuff repair remain high. Platelet-rich plasma has gained interest as a potential biological augmentation to enhance bone-tendon healing. The purpose of this study is to evaluate the clinical and structural outcomes of repeated PRP application on rotator cuff repair.
  
  
  METHODS
  Thirty-six patients underwent arthroscopic reconstruction, using knotless anchor double-row repair. Eighteen patients [10 female, 8 male; 61.2 (±9.2) years] received two applications of PRP-directly subsequent to the repair and 7 days postoperatively. Eighteen patients [11 male, 7 female; 61.4 (±6.5) years] who solely received the same technique of rotator cuff repair were matched for age. The subjective shoulder value, WORC, and the Constant-Murley score were used for clinical evaluation. MRI was performed for tendon integrity, and cuff appearances were graded according to the Sugaya classification.
  
  
  RESULTS
  We prospectively evaluated the PRP group with a minimum follow-up of 24 months. Clinical results did not show significantly differences in comparison to patients with isolated rotator cuff repair concerning CS (79 ± 13 vs. 77 ± 13; P = 0.6), SSV (90 ± 14 vs. 88 ± 16; P = 0.5) or WORC Score (90 ± 18 vs. 86 ± 20; P = 0.2). At the final follow-up, MRI showed retears in 11 % of the PRP and in 28 % of the control group (P = 0.4).
  
  
  CONCLUSIONS
  Knotless-anchor double-row repair shows good to excellent clinical results with an acceptable retear rate. Additional two-staged PRP application failed to significantly improve clinical parameters. Even though there was a trend for lower retear rates in the PRP group, it did not achieve statistical difference.
  
  
  METHODS
  Level III, Retrospective comparative study.
authors.affiliation: Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Gwinner
authors.affiliation: Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerhardt
authors.affiliation: Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Haneveld
authors.affiliation: Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. markus.scheibel@charite.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Scheibel
mesh_terms: D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D012008:Recurrence; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D053441:Suture Anchors
keywords: Autologous conditioned plasma; Growth factors; Platelet-rich plasma; Rotator cuff repair; Tendon healing