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No benefit of platelet-rich plasma found for rotator cuff healing
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SAN FRANCISCO — Using autologous platelet-rich plasma at the time of rotator cuff repair fails to have a significant positive impact on healing time as determined by ultrasound observation, according to a study presented here.
The findings were presented by Don A. Buford, MD, at the 2011 Annual Meeting of the Arthroscopy Association of North America.
Buford and colleagues concluded that the addition of platelet-rich plasma (PRP) administered in a single dose at the time of rotator cuff repair using a single-row triple-loaded suture anchor showed no benefit in healing tears measuring up to 3 cm.
Prospective study
 Don A. Buford |
The investigators performed a prospective study involving 100 patients with 3 cm tears in length or smaller who were allocated into two groups. The first group received 5 to 6cc of PRP at the tendon-bone interface at the conclusion of repair. The PRP, in this case, was autologous and prepared with a commercially-available kit. The second cohort of 50 patients did not receive PRP during treatment.
All tears involved either the supraspinatus tendon only or the supraspinatus and infraspinatus tendons, and all were repaired with at least one triple-loaded metal suture anchor. The study noted that if the tear pattern warranted further treatment, additional suture anchors and/or side-to-side sutures were also used.
Postoperative evaluations occurred in-office and consisted of shoulder ultrasound at 6 weeks, 3 months and 6 months.
“Our primary criteria, because there really is not anything in the literature to guide us, was restoration of the rotator cuff footprint lateral to our suture anchor line,” Buford said. “We wanted to see normal ultrasound signal in the tissue and no significant fluid in the subacromial bursa.”
No significant difference
Buford reported 48 of the 50 patients who received PRP went on to experience normal tendon healing with a mean duration of 16.5 weeks. Forty-seven of the patients who did not receive PRP went on to experience normal tendon healing with a mean duration of 14.5 weeks. These results were found through ANOVA statistical analysis and Tukey Value findings to be statistically insignificant, Buford noted.
“We did not find a statistically significant difference in rotator cuff healing with the addition of PRP and, in fact, our trend was actually toward more rapid healing without the addition of PRP, which is something we had not really considered," Buford said. "It may warrant further investigation.”
Buford added he would like to perform further studies for the purpose of finding a cohort that would benefit from the use of PRP.
Reference:
- Buford DA. Rotator cuff healing with and without platelet rich plasma application. Paper SS-16. Presented at the 2011 Annual Meeting of the Arthroscopy Association of North America. April 14-16. San Francisco.
- Disclosure: Buford is a member of the speakers’ bureau for CONMED Linvatec and Mitek Depuy, and is a paid consultant for CONMED Linvatec, Sonosite, Inc. and GE Healthcare.
I'd like to commend you for your approach to look at healing rate as opposed to healing percentage. What my patients are looking for now in the office is … they do not want to not move their arm for 6 weeks. They want something that is going to make their tendon heal faster, and I think this is something we should be looking into more.
– Joseph C. Tauro, MD
Moderator
Disclosure: Tauro is an unpaid consultant for, and holds stock or stock options in, Kfx Medical.
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