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Published on: January 4, 2019
Injection of Leukocyte-Poor Platelet-Rich Plasma for Moderate-to-Large Rotator Cuff Tears Does Not Improve Clinical
Chi Zhang1, You-Zhi Cai1, Yue Wang2
1Center for Sports Medicine, Hangzhou, China; First Affiliated Hospital, Zhejiang University School of Medicine and Institute of Sports Medicine of Zhejiang University, Hangzhou, China.
Leukocyte-poor platelet-rich plasma (Lp-PRP) injections after arthroscopic rotator cuff repair significantly reduced retear rates and improved fatty infiltration. While functional outcomes met minimal clinical importance, Lp-PRP did not show superior results compared to standard repair alone in this study.
Area of Science:
- Orthopedic Surgery
- Regenerative Medicine
- Biologics in Sports Medicine
Background:
- Rotator cuff tears are common, leading to pain and dysfunction.
- Arthroscopic repair is a standard treatment, but retear and fatty infiltration remain concerns.
- Platelet-rich plasma (PRP) is explored to enhance healing and repair outcomes.
Purpose of the Study:
- To evaluate the efficacy of leukocyte-poor platelet-rich plasma (Lp-PRP) in reducing retear rates, fatty infiltration, and improving functional outcomes after rotator cuff repair.
- To compare outcomes between arthroscopic rotator cuff repair with Lp-PRP injections versus repair alone.
Main Methods:
- A randomized controlled trial involving 104 patients with moderate-to-large rotator cuff tears.
- Patients were assigned to either standard double-row suture-bridge repair or repair plus three Lp-PRP injections.
- Follow-up included clinical assessments (UCLA, Constant, VAS) and MRI-based evaluation of retear and fatty infiltration (Sugaya, Goutallier) at 24 months.
Main Results:
- The Lp-PRP group showed a significantly lower retear rate (17.6% vs. 38.1%, P = .049).
- A significant difference in Goutallier grade (fatty infiltration) was observed postoperatively between groups (P = .03).
- Both groups achieved minimal clinically important differences in UCLA, Constant, and VAS scores, with no significant between-group differences in these functional outcomes.
Conclusions:
- Lp-PRP injections administered during and after arthroscopic rotator cuff repair appear to reduce retear rates and improve tendon integrity.
- While functional outcomes met clinical significance, Lp-PRP did not demonstrate superior clinical results compared to the control group in this cohort.
- Further research with larger sample sizes may be warranted to fully elucidate the clinical benefits of Lp-PRP in rotator cuff repair.
