title: Impact of Platelet-Rich Plasma on Arthroscopic Repair of Small- to Medium-Sized Rotator Cuff Tears: A Randomized Controlled Trial.
abstract: BACKGROUND
  Increased interest in using platelet-rich plasma (PRP) as an augment to rotator cuff repair warrants further investigation, particularly in smaller rotator cuff tears.
  
  
  OBJECTIVE
  To examine the effectiveness of PRP application in improving perioperative pain and function and promoting healing at 6 months after arthroscopic repair of small- or medium-sized rotator cuff tears.
  
  
  METHODS
  Randomized controlled trial; Level of evidence, 1.
  
  
  METHODS
  This was a double-blinded randomized controlled trial of patients undergoing arthroscopic repair of partial- or full-thickness rotator cuff tears of up to 3 cm who were observed for 6 months. Patients were randomized to either repair and PRP application (study group) or repair only (control group) groups. The patient-oriented outcome measures utilized were the visual analog scale (VAS), the Short Western Ontario Rotator Cuff Index (ShortWORC), the American Shoulder and Elbow Surgeons (ASES) form, and the Constant-Murley Score (CMS). Range of motion (ROM) and inflammatory and coagulation markers were measured before and after surgery. Magnetic resonance imaging was used at 6 months to assess retear and fatty infiltration rate.
  
  
  RESULTS
  Eighty-two patients (41 males) with a mean age of 59 ± 8 years were enrolled; 41 patients were included in each group. Both the PRP and control groups showed a significant improvement in their pain level based on the VAS within the first 30 days (P < .0001), with the PRP group reporting less pain than the control group (P = .012), which was clinically significantly different from days 8 through 11. The PRP group reported taking less painkillers (P = .026) than the control group within the first 30 days. All outcome measure scores and ROM improved significantly after surgery (P < .0001), with no between-group differences. No differences were observed between groups in inflammatory or coagulation marker test results (P > .05), retear (14% vs 18% full retear; P = .44), or fatty infiltration rate (P = .08).
  
  
  CONCLUSIONS
  The PRP biological augmentation for repair of small- to medium-sized rotator cuff tears has a short-term effect on perioperative pain without any significant impact on patient-oriented outcome measures or structural integrity of the repair compared with control group.
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Holtby
authors.affiliation: Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Department of Medical Imaging, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Monique
authors.initials: M
authors.lastname: Christakis
authors.affiliation: Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Maman
authors.affiliation: Department of Physical Therapy, Western University, London, Ontario, Canada.; Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Centre, London, Ontario, Canada.
authors.forename: Joy C
authors.initials: JC
authors.lastname: MacDermid
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; Division of Orthopedic Surgery, Department of Surgery, Women's College and Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Tim
authors.initials: T
authors.lastname: Dwyer
authors.affiliation: Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Centre, London, Ontario, Canada.; Division of Orthopaedic Surgery, Department of Surgery, Western University, London, Ontario, Canada.
authors.forename: George S
authors.initials: GS
authors.lastname: Athwal
authors.affiliation: Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Centre, London, Ontario, Canada.; Division of Orthopaedic Surgery, Department of Surgery, Western University, London, Ontario, Canada.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Faber
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; Division of Orthopedic Surgery, Department of Surgery, Women's College and Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Theodoropoulos
authors.affiliation: Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.; McCaig Institute for Bone and Joint Health, Calgary, Alberta, Canada.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Woodhouse
authors.affiliation: Department of Rehabilitation, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Helen
authors.initials: H
authors.lastname: Razmjou
keywords: healing; platelet-rich plasma; rotator cuff