The authors of Platelet-Rich Plasma in Arthroscopic Rotator Cuff Repair: Clinical and Radiological Results of a Prospective Randomized Controlled Trial Study at 10-Year Follow-Up sought to compare, at 10-year follow-up, the clinical and radiological outcomes of arthroscopic rotator cuff repair with or without the addition of platelet-rich plasma (PRP) over the tendon-bone interface at the end of
the surgical procedure.
Patients were randomly divided into 2 groups: 26 received PRP and 27 served as controls. 38 (71%) patients (median age 71 years) were re-evaluated at least 10 years after the index procedure performed by an individual highly experienced surgeon. The patients in the two groups were similar.
The clinical outcomes were not better for the shoulders receiving PRP
While the mean ASES score was higher for the PRP group (100) than for the non-PRP group (93), the difference did not approach clinical significance (see Establishing clinically significant outcome after arthroscopic rotator cuff repair).
On average, 37% of the operated patients had a re-rupture on ultrasound examination, regardless of whether PRP was used or not (PRP group: 35%; control group: 38%; P . 1.0000).
Interestingly, the clinical outcomes were essentially the same whether the repair remained intact or not.
While the average Constant score was higher for patients with intact cuffs in comparison to those with re-tears, the difference failed to reach clinical significance (see Investigating minimal clinically important difference for Constant score in patients undergoing rotator cuff surgery).
The authors concluded that in comparison to patients not receiving PRP, patients treated with PRP did not have better clinical outcomes and did not have lower re-tear rates of the repaired tendons. These finding are similar to those reported by the authors of The clinical efficacy of leukocyte-poor platelet-rich plasma in arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials in which the clinical effects of PRP failed to reach clinical significance.
Comment: PRP can be an expensive adjunct to rotator cuff repair and the expense may not be covered by the patient's insurance. Further evidence is needed to support the value (benefit/cost) of PRP as an adjunct to rotator cuff repair.
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