title: Platelet-rich plasma supplementation in arthroscopic repair of full-thickness rotator cuff tears: a randomized clinical trial.
abstract: BACKGROUND
  Results on the effectiveness of PRP supplementation in arthroscopic rotator cuff repair are conflicting, making it difficult to draw definitive conclusions.
  
  
  METHODS
  This was a prospective, randomized, and double-blind study with two groups of 20 patients each (PRP group and control group). Degenerative supraspinatus full-thickness tears grade C2-C3 were subjected to arthroscopic repair; PRP supplementation was given to patients in the PRP group. The outcomes were assessed by DASH, Constant scales, and ultrasound before and 6 months after surgery. Pain measured by VAS was evaluated preoperatively and 7 and 30 days after surgery.
  
  
  RESULTS
  The two groups did not differ significantly by age, sex, and dominance of the affected side. In all surgical procedures, a long head of the biceps tenotomy and single-row repair were performed. The preoperative VAS was 5.6 ± 2.4 in PRP group and 6.4 ± 1.5 in the control group (p > 0.05). The group supplemented with PRP reported a VAS significantly better in the first week (2.5 ± 1.9 vs 5.3 ± 2.1, p < 0.05) and during the first month after surgery (1.5 ± 1.0 vs 3.2 ± 1.7, p < 0.05) compared to the control group. The preoperative Constant and DASH scores were 39.95 ± 12 and 51 ± 15.2, respectively, in the PRP group and 41 ± 11 (p > 0.05) and 45 ± 12.6 (p > 0.05) in the control group. The average Constant score improved significantly after 6 months to 81 ± 11.2 (p < 0.05) in the PRP group and 78.5 ± 9 (p < 0.05) in the control group. No differences were noted between the two groups (p > 0.05). The DASH score after 6 months was 17.4 ± 8 (p < 0.05) for the treatment group (the PRP group) and 21 ± 8.4 (p < 0.05) for the control group. No statistically significant differences were found as regards the DASH score in the two groups after 6 months (p > 0.05). The two groups showed no differences in the ultrasound evaluation after 6 months either. No re-ruptures occurred in either group.
  
  
  CONCLUSIONS
  PRP leads to a reduction in pain during a short-term follow-up. Pain reduction allows for a more rapid recovery of mobilization and improvement in functionality.
  
  
  METHODS
  Randomized controlled trial, Level of evidence, 1.
authors.affiliation: U.O. Clinica Ortopedica e Traumatologica, Centro Traumatologico Ortopedico, Università degli Studi di Milano, Milan, Italy. riccardo.dambrosi@hotmail.it.
authors.forename: R
authors.identifier: http://orcid.org/0000-0002-1216-792X
authors.initials: R
authors.lastname: D'Ambrosi
authors.affiliation: U.O. Clinica Ortopedica e Traumatologica, Centro Traumatologico Ortopedico, Università degli Studi di Milano, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Palumbo
authors.affiliation: U.O. Clinica Ortopedica e Traumatologica, Centro Traumatologico Ortopedico, Università degli Studi di Milano, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Paronzini
authors.affiliation: IRCCS Policlinico San Donato, San Donato Milanese, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Ragone
authors.affiliation: U.O. Clinica Ortopedica e Traumatologica, Centro Traumatologico Ortopedico, Università degli Studi di Milano, Milan, Italy.
authors.forename: R M
authors.initials: RM
authors.lastname: Facchini
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D016059:Range of Motion, Articular; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Full-thickness; Platelet-rich plasma; Regenerative medicine; Rotator cuff tears; Shoulder arthroscopy; Ultrasound evaluation