Purpose
To investigate the effect of delayed application of leukocyte-rich platelet-rich plasma
(PRP) on rotator cuff repair results as assessed by outcome scores and imaging at
one year.
Methods
Patients with a symptomatic rotator cuff tear awaiting arthroscopic repair were approached
to take part in the study. Final eligibility for the study was confirmed at the time
of surgery. A total of 97 patients were randomized to an ultrasound guided injection
of leukocyte-rich PRP or normal saline between 10 and 14 days postsurgery. A total
of 87 patients completed clinical evaluation and underwent magnetic resonance imaging
imaging at 1 year. Outcome scores included the American Shoulder and Elbow Score,
Constant score, Western Ontario Rotator Cuff Index, and the Disabilities of the Arm,
Shoulder and Hand Score. Structural integrity of the repair was assessed according
to the Sugaya grading. Muscle fatty infiltration was assessed on magnetic resonance
imaging using the Goutallier classification.
Results
At 1 year postsurgery, there was no significant difference between the treatment groups
on any of the patient-reported outcome measures or Constant score. On postoperative
imaging analysis, there was no difference in the retear rates (Sugaya 4 and 5) between
the groups (21% in control group vs 15.3% in PRP group). Fatty infiltration on postoperative
imaging was found to be significantly higher in the normal saline group compared with
the PRP group (Kendall’s tau-b P = .032).
Conclusions
The delayed application of PRP postrotator cuff repair did not improve function as
measured by patient-reported outcome measures and Constant score at 1 year postoperatively.
Level of Evidence
Level II, prospective randomized therapeutic trial.
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Article info
Publication history
Published online: November 27, 2019
Accepted:
September 13,
2019
Received:
April 21,
2019
See commentary on page 658Footnotes
The authors report the following potential conflicts of interest or sources of funding: This study was funded by Joint Action, the Orthopaedic Research Appeal of the British Orthopaedic Association with a restricted grant. M.S. reports a paid consultancy from Smith & Nephew and unpaid consultancy from Ortho RTI, a grant from Smith & Nephew to investigate Cargel in vitro, and paid royalties from Arthrex. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
This study received institutional review board approval before commencement (IRAS Ref: 27416).
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
