Platelet-Rich Plasma for Arthroscopic Repair of Large to Massive Rotator Cuff Tears

肩袖 眼泪 富血小板血浆 医学 外科 血小板 内科学
作者
Chris Hyunchul Jo,Ji Sun Shin,Young Gil Lee,Won Hyoung Shin,Hyang Kim,Seung Yeon Lee,Kang Sup Yoon,Sue Shin
出处
期刊:American Journal of Sports Medicine [SAGE]
卷期号:41 (10): 2240-2248 被引量:204
标识
DOI:10.1177/0363546513497925
摘要

Background: Platelet-rich plasma (PRP) is expected to have a biological augmentation potential in the healing of various diseases and injuries, including rotator cuff tears. However, few evaluations have been performed specifically for large to massive tears. Purpose: To assess the efficacy of PRP augmentation in patients undergoing arthroscopic repair for large to massive rotator cuff tears. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 48 patients scheduled for arthroscopic repair of large to massive rotator cuff tears were randomly assigned to receive either PRP-augmented (PRP group) or conventional treatment (conventional group). In the PRP group, 3 PRP gels (3 × 3 mL) were applied to each patient between the torn end and the greater tuberosity. The primary outcome measure was the retear rate assessed by magnetic resonance imaging (MRI) or computed tomographic arthrography (CTA) at a minimum of 9 months after surgery. Secondary outcome measures included pain, range of motion, muscle strength, overall satisfaction, functional scores, and the change in cross-sectional area (CSA) of the supraspinatus. Results: The retear rate of the PRP group (20.0%) was significantly lower than that of the conventional group (55.6%) ( P = .023). Clinical outcomes showed no statistical difference between the 2 groups (all P > .05) except for the overall function ( P = .043). The change in 1-year postoperative and immediately postoperative CSA was significantly different between the 2 groups: –15.54 ± 94.34 mm 2 in the PRP group versus −85.62 ± 103.57 mm 2 in the conventional group ( P = .047). Conclusion: The application of PRP for large to massive rotator cuff repairs significantly improved structural outcomes, as evidenced by a decreased retear rate and increased CSA of the supraspinatus compared with repairs without PRP augmentation. While there was no significant difference in clinical outcomes except the overall shoulder function after 1-year follow-up, better structural outcomes in the PRP group might suggest improved clinical outcomes at longer term follow-up.
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