Leukocyte-poor PRP injections during, after rotator cuff repair may reduce retear rate
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Repeated leukocyte-poor platelet-rich plasma injections during and after double-row suture-bridge arthroscopic rotator cuff repair may reduce the retear rate and improve Goutallier grade and clinical outcomes, according to study results.
Researchers randomly assigned 104 patients with moderate to large rotator cuff tears to undergo either double-row suture-bridge arthroscopic rotator cuff repair alone (control group; n=52) or followed by three leukocyte-poor PRP injections at the tendon repair site during surgery and 7 and 14 days after surgery (study group; n=52). Researchers assessed the integrity and fatty infiltration of repaired tissue with MRI using the Sugaya classification and Goutallier grade classification at 24 months postoperatively. Researchers also collected University of California, Los Angeles (UCLA) shoulder rating scale score, Constant score and VAS score before surgery and 1, 6, 12 and 24 months after surgery.
Of the 89 patients available for 24-month follow-up, results showed an increase in the mean UCLA score from approximately 14.8 to 29.37 in the control group and from approximately 13.74 to 30.14 in the study group. Researchers also found an increase in mean Constant score from approximately 46.56 to 86.83 in the control group and from approximately 44.37 to 88.8 in the study group, as well as a decrease in VAS score from approximately 3.22 to 0.97 in the control group and from approximately 3.49 to 1.16 in the study group. Researchers noted all differences between preoperative and postoperative UCLA scores, Constant scores and VAS scores achieved minimal clinically important differences proposed for arthroscopic rotator cuff repair.
Overall, 76 patients had MRI performed at 24 months postoperatively. Patients in the study group had a 17.6% retear rate vs. a 38.1% retear rate in the control group, according to results. Although Goutallier grade was not significantly different between the two groups preoperatively, researchers found a significant difference in Goutallier grade between the groups postoperatively. Researchers noted no complications in either group.
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