The Efficacy of Platelet-rich Plasma in Arthroscopic Rotator Cuff Repairs: A Narrative Review
Journal of Clinical Orthopaedics | Vol 9 | Issue 2 | July-December 2024 | page: 22-25 | Nihar Modi, Prasad Bhagunde, Damini Shah
DOI: https://doi.org/10.13107/jcorth.2024.v09i02.650
Submitted Date: 15 Jul 2024, Review Date: 09 Aug 2024, Accepted Date: 19 Sep 2024 & Published Date: 10 Dec 2024
Author: Prasad Bhagunde [1, 2, 3, 4], Nihar Modi [1, 3, 5], Daminir shah [6]
[1] Department of Orthopaedics, Sona Medical Centre, Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, Saifee Hospital, Mumbai, Maharashtra, India.
[3] Department of Orthopaedics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.
[4] Department of Orthopaedics, Breach Candy Hospital Trust, Mumbai, Maharashtra, India.
[5] Department of Orthopaedics, Criticare Asia Multispeciality Hospital and Research Centre, Mumbai, Maharashtra, India.
[6] Novo Tissue Bank and Research Centre, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Nihar Modi,
Consultant Orthopaedic Surgeon, Sona Medical Centre, Jaslok Hospital and Research Centre, Criticare Asia Multispeciality Hospital and Research Centre, Mumbai, Maharashtra, India.
E-mail: modi.nihar95@gmail.com
Abstract
Rotator cuff tears are one of the most prevalent musculoskeletal disorders, with a significant risk of retear following repair. Platelet-rich plasma (PRP) has emerged as a potential adjunct to enhance healing through mechanisms including growth factor release, anti-inflammatory effects, and angiogenesis. This narrative review evaluates the efficacy of PRP augmentation in arthroscopic rotator cuff repairs by examining recent studies and meta-analyses. Findings indicate that PRP, particularly leukocyte-poor PRP, shows promise in improving pain and functional outcomes, and reducing retear rates, though its cost-effectiveness and optimal application protocols remain uncertain. Limitations of current studies and avenues for future research are also discussed.
Keywords: Platelet-rich plasma, Arthroscopic rotator Cuff repairs, orthobiologics, PRP
References
1. Snow M, Hussain F, Pagkalos J, Kowalski T, Green M, Massoud S, James S. The Effect of Delayed Injection of Leukocyte-Rich Platelet-Rich Plasma Following Rotator Cuff Repair on Patient Function: A Randomized Double-Blind Controlled Trial. Arthroscopy. 2020 Mar;36(3):648-657.
2. Ahmad Z, Ang S, Rushton N, Harvey A, Akhtar K, Dawson-Bowling S, Noorani A. Platelet-Rich Plasma Augmentation of Arthroscopic Rotator Cuff Repair Lowers Retear Rates and Improves Short-Term Postoperative Functional Outcome Scores: A Systematic Review of Meta-Analyses. Arthrosc Sports Med Rehabil. 2022 Feb 5;4(2):e823-e833.
3. Samuelson EM, Odum SM, Fleischli JE. The Cost-Effectiveness of Using Platelet-Rich Plasma During Rotator Cuff Repair: A Markov Model Analysis. Arthroscopy. 2016 Jul;32(7):1237-44.
4. Routledge JC, Saber AY, Pennington N, Gupta N. Re-Tear Rates Following Rotator Cuff Repair Surgery. Cureus. 2023 Jan 31;15(1):e34426.
5. Liu B, Jeong HJ, Yeo JH, Oh JH. Efficacy of Intraoperative Platelet-Rich Plasma Augmentation and Postoperative Platelet-Rich Plasma Booster Injection for Rotator Cuff Healing: A Randomized Controlled Clinical Trial. Orthop J Sports Med. 2021 Jun 4;9(6):23259671211006100.
6. Syed, A. N., Landrum, K., & Ganley, T. J. (2024). Platelet-rich plasma and other injectables in the young athlete. Journal of the Pediatric Orthopaedic Society of North America, 6, 100008.
7. Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med. 2009 Nov;37(11):2259-72.
8. Hurley ET, Danilkowicz RM, Klifto CS. Editorial Commentary: Platelet-Rich Plasma Injections Produced a Significant Improvement in Most Patients With Rotator Cuff Tendinopathy. Arthroscopy. 2023 Sep;39(9):2009-2011.
9. Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author’s Perspective. J Cutan Aesthet Surg. 2014;7(4):189-197.
10. Hak A, Rajaratnam K, Ayeni OR, Moro J, Peterson D, Sprague S, Bhandari M. A Double-Blinded Placebo Randomized Controlled Trial Evaluating Short-term Efficacy of Platelet-Rich Plasma in Reducing Postoperative Pain After Arthroscopic Rotator Cuff Repair: A Pilot Study. Sports Health. 2015 Jan;7(1):58-66.
11. Barber FA, Hrnack SA, Snyder SJ, Hapa O. Rotator cuff repair healing influenced by platelet-rich plasma construct augmentation. Arthroscopy. 2011 Aug;27(8):1029-35.
12. Malavolta EA, Gracitelli ME, Ferreira Neto AA, Assunção JH, Bordalo-Rodrigues M, de Camargo OP. Platelet-rich plasma in rotator cuff repair: a prospective randomized study. Am J Sports Med. 2014 Oct;42(10):2446-54.
13. Flury M, Rickenbacher D, Schwyzer HK, Jung C, Schneider MM, Stahnke K, Goldhahn J, Audigé L. Does Pure Platelet-Rich Plasma Affect Postoperative Clinical Outcomes After Arthroscopic Rotator Cuff Repair? A Randomized Controlled Trial. Am J Sports Med. 2016 Aug;44(8):2136-46.
14. Trantos IA, Vasiliadis ES, Giannoulis FS, Pappa E, Kakridonis F, Pneumaticos SG. The Effect of PRP Augmentation of Arthroscopic Repairs of Shoulder Rotator Cuff Tears on Postoperative Clinical Scores and Retear Rates: A Systematic Review and Meta-Analysis. J Clin Med. 2023 Jan 11;12(2):581.
15. Ryan J, Imbergamo C, Sudah S, Kirchner G, Greenberg P, Monica J, Gatt C. Platelet-Rich Product Supplementation in Rotator Cuff Repair Reduces Retear Rates and Improves Clinical Outcomes: A Meta-analysis of Randomized Controlled Trials. Arthroscopy. 2021 Aug;37(8):2608-2624.
16. Rossi LA, Gorodischer TD, Camino P, Brandariz RN, Tanoira I, Piuzzi NS, Ranalletta M. Leukocyte-Poor Platelet-Rich Plasma as an Adjuvant to Arthroscopic Rotator Cuff Repair Reduces the Retear Rate But Does Not Improve Functional Outcomes: A Double-Blind Randomized Controlled Trial. Am J Sports Med. 2024 May;52(6):1403-1410.
17. Wang A, McCann P, Colliver J, Koh E, Ackland T, Joss B, Zheng M, Breidahl B. Do postoperative platelet-rich plasma injections accelerate early tendon healing and functional recovery after arthroscopic supraspinatus repair? A randomized controlled trial. Am J Sports Med. 2015 Jun;43(6):1430-7.
18. Vavken P, Sadoghi P, Palmer M, Rosso C, Mueller AM, Szoelloesy G, Valderrabano V. Platelet-Rich Plasma Reduces Retear Rates After Arthroscopic Repair of Small- and Medium-Sized Rotator Cuff Tears but Is Not Cost-Effective. Am J Sports Med. 2015 Dec;43(12):3071-6.
19. Nunes B, Martins R, Linhares D, Azevedo L, Canadas R, Gutierres M. Effect of Platelet-Rich Plasma Dosing for Healing after Arthroscopic Cuff Repair Compared with Surgery Alone: A Systematic Review and Meta-Analysis. Med Sci Sports Exerc. 2024 May 1;56(5):796-804.
20. Pandey V, Bandi A, Madi S, Agarwal L, Acharya KK, Maddukuri S, Sambhaji C, Willems WJ. Does application of moderately concentrated platelet-rich plasma improve clinical and structural outcome after arthroscopic repair of medium-sized to large rotator cuff tear? A randomized controlled trial. J Shoulder Elbow Surg. 2016 Aug;25(8):1312-22.
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