This article is more than 5 years old. Information may no longer be current.

Specialized PRP treatment shows no improvement in rotator cuff healing

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Use of a platelet-rich fibrin matrix on the tendon-bone interface at the time of rotator cuff repair has “no significant effect” on manual muscle strength, clinical rating scales, tendon healing or vascularity when compared with repair alone, according to results presented at the 2011 American Orthopaedic Society for Sports Medicine Specialty Day Meeting.

Scott A. Rodeo

“Our study on 79 patients who received platelet-rich plasma with a fibrin matrix demonstrated no real differences in healing in a tendon-to-bone rotator cuff repair,” lead author and Orthopedics Today Editorial Board member Scott A. Rodeo, MD, stated in an American Orthopaedic Society for Sports Medicine (AOSSM) release. “In fact, this preliminary analysis suggests that the [platelet-rich fibrin matrix] PRFM, as used in this study, may have a negative effect on healing. However, this data should be viewed as preliminary, and further study is required.”

RPFM as a ‘significant predictor’

Rodeo and his colleagues performed a prospective, randomized trial of 79 patients who underwent arthroscopic rotator cuff repair and had a minimum follow-up of 1 year. Patients in the study were randomized to receive either a PRFM treatment or undergo standard repair.

In the experimental group, surgeons attached the PRFM to the suture at the interface of the tendon and the greater tuberosity. Standardized repair techniques were used, and postoperative rehabilitation was the same in the groups. The investigators used a primary outcome of tendon healing evaluated by ultrasound at 6 and 12 weeks, as well as secondary outcomes of strength testing, and ASES and L’Insalata evaluations. Patients and evaluators were blinded to treatment groups, and a logistic regression model was used to predict outcomes based on tear severity, repair type, treatment type and platelet count.

According to the release, Rodeo reported that there were no differences in tendon-to-bone healing between the groups. Rodeo also noted no significant differences in healing by ultrasound at 6 and 12 weeks, as well as no differences in ASES, L’Insalata and strength scores between the groups. Vascularity of the repaired tendons was similar between the groups, and platelet count had no impact on healing. Furthermore, logistic regression analysis found PRFM to be “a significant predictor” for a tendon defect at 12 weeks.

More study needed

The study authors noted the results could be due to variability in platelet recovery, platelet activation, and kinetics of cytokine release from the PRFM.

“Additional research needs to be performed to figure out the mechanisms for why [platelet-rich plasma] is successful in healing certain areas of the body and not others,” Rodeo stated in the release. “With more study, we will continue to learn new procedures for improving orthopedic surgery outcomes.”

References:

• Rodeo SA, et al. The effect of platelet-rich fibrin matrix on rotator cuff tendon healing: A prospective, randomized clinical study. Paper 9624. Presented at the 2011 American Orthopaedic Society for Sports Medicine Specialty Day Meeting. Feb. 19, 2011. San Diego.
• www.aossm.org

Disclosure: The authors have reported no relevant financial disclosures.

Follow ORTHOSuperSite.com on Twitter