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Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

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.

Materials and 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.

Level of evidence

Level III, Retrospective comparative study.

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Author notes

    Authors and Affiliations

    1. Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

      Clemens Gwinner, Christian Gerhardt, Hendrik Haneveld & Markus Scheibel

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    1. Clemens Gwinner
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    2. Christian Gerhardt
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    3. Hendrik Haneveld
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    4. Markus Scheibel
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    Correspondence to Markus Scheibel.

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    Funding

    All authors would like to state that no outside funding or grants were received that assisted in the study.

    Conflict of interest

    Markus Scheibel and Christian Gerhardt are consultants for Arthrex. Upon that, Clemens Gwinner, Christian Gerhardt, Hendrik Haneveld, Markus Scheibel, their immediate family, and any research foundation with which they are affiliated state, that they have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

    Ethical statement

    Institutional Review Board approval was provided by University Hospital Ethics Commission; No. EA1/264/15.

    Additional information

    C. Gwinner and C. Gerhardt contributed equally to this paper.

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    Gwinner, C., Gerhardt, C., Haneveld, H. et al. Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis. Arch Orthop Trauma Surg 136, 1165–1171 (2016). https://doi.org/10.1007/s00402-016-2499-4

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    • DOI: https://doi.org/10.1007/s00402-016-2499-4

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