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Repeated PRP injections after arthroscopic supraspinatus repair provided no additional benefit
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At midterm review after supraspinatus repair, results showed significant postoperative clinical improvements and high levels of patient satisfaction regardless of whether ultrasound-guided injections of platelet-rich plasma were used.
Allan Wang, PhD, FRACS, and colleagues randomly assigned 60 patients with rotator cuff tears to receive either two ultrasound-guided injections of PRP to the tendon repair site at 7 days and 14 days after double-row arthroscopic supraspinatus repair or not. Researchers collected Constant score, QuickDASH questionnaire scores, Oxford shoulder score and VAS for pain, and obtained platelet concentrate using the Autologous Conditioned Plasma System (Arthrex). At a mean of 3.5 years after surgery, 91.7% of patients underwent a clinical review and MRI.
Results showed no difference between the groups for any of the patient-reported outcome measures. Researchers found a significantly higher Constant strength subscale score among the PRP group, despite no differences found between the groups for the subjective and range of motion subscales of the Constant score. According to results, 66.7% and 64.3% of patients in the PRP group and control group, respectively, were rated as Sugaya grade 1. Compared with two patients in the control group who experienced symptomatic full-thickness retears within the first 16 weeks after surgery, researchers found two patients in the PRP group experienced symptomatic partial-thickness retears between 16 weeks and a mean 3.5-year follow-up.
“Arthroscopic repair of small- and medium-sized rotator cuff tears are generally successful in relieving pain and disability. This randomized controlled trial was conducted to determine if the rotator cuff tendon repair site would be more robust in the midterm after surgery, with improved tendon integrity and clinical function, after receiving postoperative PRP injections under ultrasound guidance,” Wang told Healio.com/Orthopedics. “This study showed equivalent MRI tendon healing rates between PRP treated and control groups. However, the Constant subscale score for pain free abduction strength was greater in the PRP group, suggesting postoperative administration of PRP may improve the quality of tendon repair and remodeling.” – by Casey Tingle
Disclosures: Wang reports shares in Orthocell. For the early outcomes collected as part of this study, Arthrex provided a research grant to assist with the early clinical evaluations as well as donated disposable syringes. Medivenn provided a research grant that assisted with the cost of 3-year to 4-year MRI scans. Please see the full study for a list of all other authors’ relevant financial disclosures.
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