Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis

Failure rates after arthroscopic rotator cuff repair remain high. Platelet-rich plasma has gained interest as a potential biological augmentation to enhance bone-tendon healing. The purpose of this study is to evaluate the clinical and structural outcomes of repeated PRP application on rotator cuff repair.

Thirty-six patients underwent arthroscopic reconstruction, using knotless anchor double-row repair. Eighteen patients [10 female, 8 male; 61.2 (±9.2) years] received two applications of PRP-directly subsequent to the repair and 7 days postoperatively. Eighteen patients [11 male, 7 female; 61.4 (±6.5) years] who solely received the same technique of rotator cuff repair were matched for age. The subjective shoulder value, WORC, and the Constant-Murley score were used for clinical evaluation. MRI was performed for tendon integrity, and cuff appearances were graded according to the Sugaya classification.

We prospectively evaluated the PRP group with a minimum follow-up of 24 months. Clinical results did not show significantly differences in comparison to patients with isolated rotator cuff repair concerning CS (79 ± 13 vs. 77 ± 13; P = 0.6), SSV (90 ± 14 vs. 88 ± 16; P = 0.5) or WORC Score (90 ± 18 vs. 86 ± 20; P = 0.2). At the final follow-up, MRI showed retears in 11 % of the PRP and in 28 % of the control group (P = 0.4).

Knotless-anchor double-row repair shows good to excellent clinical results with an acceptable retear rate. Additional two-staged PRP application failed to significantly improve clinical parameters. Even though there was a trend for lower retear rates in the PRP group, it did not achieve statistical difference.

Level III, Retrospective comparative study.