The Role of Platelet-Rich Plasma in Rotator Cuff Repair

  • Pietro RandelliEmail author
  • Vincenza Ragone
  • Paolo Cabitza


Rotator cuff tendon tears are a common source of shoulder pain and combine both traumatic and degenerative elements. The incidence of this condition is increasing along with an aging population. The management of rotator cuff tears is complex and multifactorial. Partial-thickness tears may heal with conservative management and avoidance of predisposing factors. Operative treatment allows primary repair to be performed as either an open or an arthroscopic procedure. Despite satisfactory results for primary rotator cuff repair, the incidence of persistent tendon defects or retears is still significant.


Rotator Cuff Rotator Cuff Tear Rotator Cuff Repair Rotator Cuff Tendon Arthroscopic Rotator Cuff Repair 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg. 1995;77A:10–5.Google Scholar
  2. 2.
    Lafosse L, Jost B, Reiland Y, Audebert S, Toussaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg. 2007;89A:1184–93.Google Scholar
  3. 3.
    Lichtenberg S, Liem D, Magosch P, Habermeyer P. Influence of tendon healing after arthroscopic rotator cuff repair on clinical outcome using single-row Mason-Allen suture technique: a prospective, MRI controlled study. Knee Surg Sports Traumatol Arthrosc. 2006;14:1200–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Cole BJ, McCarty 3rd LP, Kang RW, Alford W, Lewis PB, Hayden JK. Arthroscopic rotator cuff repair: prospective functional outcome and repair integrity at minimum 2-year follow-up. J Shoulder Elbow Surg. 2007;16:579–85.PubMedCrossRefGoogle Scholar
  5. 5.
    Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg. 2005;87A:1229–40.CrossRefGoogle Scholar
  6. 6.
    Burkhart SS, Danaceau SM, Pearce Jr CE. Arthroscopic rotator cuff repair: analysis of results by tear size and by repair technique-margin convergence versus direct tendon-to-bone repair. Arthroscopy. 2001;17:905–12.PubMedCrossRefGoogle Scholar
  7. 7.
    Cheung EV, Silverio L, Sperling JW. Strategies in biologic augmentation of rotator cuff repair: a review. Clin Orthop Relat Res. 2010;468:1476–84.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Galatz LM, Sandell LJ, Rothermich SY, Das R, Mastny A, Havlioglu N, et al. Characteristics of the rat supraspinatus tendon during tendon-to-bone healing after acute injury. J Orthop Res. 2006;24:541–50.PubMedCrossRefGoogle Scholar
  9. 9.
    Rodeo SA, Arnoczky SP, Torzilli PA, Hidaka C, Warren RF. Tendon-healing in a bone tunnel: a biomechanical and histological study in the dog. J Bone Joint Surg. 1993;75A:1795–803.Google Scholar
  10. 10.
    Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg. 2004;86A:219–24.Google Scholar
  11. 11.
    Lafosse L, Brzoska R, Toussaint B, Gobezie R. The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. J Bone Joint Surg. 2008;90A:275–86.Google Scholar
  12. 12.
    Levy O, Venkateswaran B, Even T, Ravenscroft M, Copeland S. Mid-term clinical and sonographic outcome of arthroscopic repair of the rotator cuff. J Bone Joint Surg. 2008;90B:1341–7.CrossRefGoogle Scholar
  13. 13.
    Eppley BL, Woodell JE, Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg. 2004;114:1502–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Everts PA, Knape JT, Weibrich G, Schonberger JP, Hoffmann J, Overdevest EP, et al. Platelet-rich plasma and platelet gel: a review. J Extra Corp Technol. 2006;38:174–87.Google Scholar
  15. 15.
    Mishra A, Harmon K, Woodall J, Vieira A. Sports medicine applications of platelet rich plasma. Curr Pharm Biotechnol. 2012;13:1185–95.PubMedCrossRefGoogle Scholar
  16. 16.
    Sundman EA, Cole BJ, Fortier LA. Growth factor and catabolic cytokine concentrations are influenced by the cellular composition of platelet-rich plasma. Am J Sports Med. 2011;39:2135–40.PubMedCrossRefGoogle Scholar
  17. 17.
    Dohan Ehrenfest DM, Bielecki T, Mishra A, Borzini P, Inchingolo F, Sammartino G, et al. In search of a consensus terminology in the field of platelet concentrates for surgical use: platelet-rich plasma (PRP), platelet-rich fibrin (PRF), fibrin gel polymerization and leukocytes. Curr Pharm Biotechnol. 2012;13:1131–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Randelli PS, Arrigoni P, Cabitza P, Volpi P, Maffulli N. Autologous platelet rich plasma for arthroscopic rotator cuff repair. A pilot study. Disabil Rehabil. 2008;30:1584–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Castricini R, Longo UG, De Benedetto M, Panfoli N, Pirani P, Zini R, et al. Platelet-rich plasma augmentation for arthroscopic rotator cuff repair: a randomized controlled trial. Am J Sports Med. 2011;39:258–65.PubMedCrossRefGoogle Scholar
  20. 20.
    Randelli P, Arrigoni P, Ragone V, Aliprandi A. Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Shoulder Elbow Surg. 2011;20:518–28.PubMedCrossRefGoogle Scholar
  21. 21.
    Jo CH, Kim JE, Yoon KS, Lee JH, Kang SB, Lee JH, et al. Does Platelet-Rich Plasma accelerate recovery after rotator cuff repair? A prospective cohort study. Am J Sports Med. 2011;39:2082–90.PubMedCrossRefGoogle Scholar
  22. 22.
    Barber FA, Hrnack SA, Snyder SJ, Hapa O. Rotator cuff repair healing influenced by platelet rich plasma construct augmentation. Arthroscopy. 2011;27:1029–35.PubMedCrossRefGoogle Scholar
  23. 23.
    Gumina S, Campagna V, Ferrazza G, Giannicola G, Fratalocchi F, Milani A, et al. Use of platelet-leukocyte membrane in arthroscopic repair of large rotator cuff tears: a prospective randomized study. J Bone Joint Surg. 2012;94A:1345–52.CrossRefGoogle Scholar
  24. 24.
    Rodeo SA, Delos D, Williams RJ, Adler RS, Pearle A, Warren RF. The effect of platelet-rich fibrin matrix on rotator cuff tendon healing: a prospective, randomized clinical study. Am J Sports Med. 2012;40:1234–41.PubMedCrossRefGoogle Scholar
  25. 25.
    Bergeson AG, Tashjian RZ, Greis PE, Crim J, Stoddard GJ, Burks RT. Effects of platelet-rich fibrin matrix on repair integrity of at-risk rotator cuff tears. Am J Sports Med. 2012;40:286–93.PubMedCrossRefGoogle Scholar
  26. 26.
    Arnoczky SP. Platelet-rich plasma augmentation of rotator cuff repair: letter. Am J Sports Med. 2011;39:np8–9.PubMedGoogle Scholar
  27. 27.
    Namazi H. Letter to the editor. Curr Med Res Opin. 2012;28:1755.PubMedCrossRefGoogle Scholar
  28. 28.
    Kakudo N, Minakata T, Mitsui T, Kushida S, Notodihardjo FZ, Kusumoto K. Proliferation-promoting effect of platelet-rich plasma on human adipose-derived stem cells and human dermal fibroblasts. Plast Reconstr Surg. 2008;122:1352–60.PubMedCrossRefGoogle Scholar
  29. 29.
    Savitskaya YA, Izaguirre A, Sierra L, Perez F, Cruz F, Villalobos E, et al. Effect of angiogenesis-related cytokines on rotator cuff disease: the search for sensitive biomarkers of early tendon degeneration. Clin Med Insights Arthritis Musculoskelet Disord. 2011;4:43–53.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Hoppe S, Alini M, Benneker LM, Milz S, Boileau P, Zumstein MA. Tenocytes of chronic rotator cuff tendon tears can be stimulated by platelet-released growth factors. J Shoulder Elbow Surg. 2013;22:340–9.PubMedCrossRefGoogle Scholar
  31. 31.
    Jo CH, Kim JE, Yoon KS, Shin S. Platelet-rich plasma stimulates cell proliferation and enhances matrix gene expression and synthesis in tenocytes from human rotator cuff tendons with degenerative tears. Am J Sports Med. 2012;40:1035–45.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Pietro Randelli
    • 1
    Email author
  • Vincenza Ragone
    • 1
  • Paolo Cabitza
    • 1
  1. 1.2nd Department of OrthopaedicsPoliclinico San Donato IRCCS, University of MilanS. Donato Milanese, MilanItaly

Personalised recommendations