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The Effect of Platelet-Rich Fibrin Matrix at the Time of Gluteus Medius Repair: A Case-Control Study

      Introduction

      The purpose of this study was to evaluate the effect of Platelet-Rich Fibrin Matrix (PRFM) on outcomes after surgical repair of gluteus medius tendons.

      Methods

      This is a retrospective review of prospectively-collected data comparing a single surgeon's case patients who underwent gluteus medius repair with PRFM to control patients without PRFM. Preoperative characteristics (gender, age, laterality, surgical history, duration and mechanism of symptoms, gait/limp, presence of femoroacetabular impingement, tear grade/size, presence of atrophy, and PROs), intraoperative characteristics (surgical approach, repair technique, concomitant surgery), and postoperative outcomes at a minimum 2-years (retear, PROs) were recorded. A multivariate analysis of variance (MANOVA) was used to test for differences in continuous demographic variables and postoperative-only scores between cohorts, chi-squared-tests for categorical variables, and a repeated measures-ANOVA was performed to test for the effects of PRFM. We also assessed for inter-observer variation for grading adductor tendon tears.

      Results

      In total, the gluteus medius repair without PRFM [(-)PRFM] cohort included 29 patients (25F/4M; 15R/4L) with a mean age of 63.09±12.0 years. The gluteus medius repair with PRFM [(+)PRFM] cohort included 18 patients (16 female, 2 male; 6 right, 12 left) with a mean age of 60.26±8.8 years. There were no differences in patient preoperative variables or intraoperative characteristics. While there was a significant effect of surgical intervention on VAS-Pain, HOS-ADL, HOS-SS, and mHHS, the utilization of PRFM had no significant effect on outcome. Linear models showed a significant positive effect of PRFM only on postoperative SF-12 Physical and IHOT-12 scores.

      Conclusion

      PRFM augmentation does not appear to have an effect on gluteus medius tendon repair in terms of pain or retear, but may have a role in improving subjective outcomes of overall and hip-specific physical functioning. Future longer-term evaluations with prospective, randomized protocols are necessary to further delineate any significant efficacy with PRFM use in this setting.