Leukocyte-rich and Leukocyte-poor Platelet-rich Plasma in Rotator Cuff Repair: A Meta-analysis

To systematically review of randomized controlled trials (RCTs) to compared the effects of leukocyte-rich and leukocyte-poor platelet-rich plasma in arthroscopic rotator cuff repair. Two independent reviewers comprehensively searched PubMed, Embase, and Cochrane library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comparison of leukocyte-rich platelet-rich plasma or leukocyte-poor platelet-rich plasma in rotator cuff repair in a level I RCTs. Methodological quality assessment was carried out using Cochrane Review Manager 5.3 software. P<0.05 was considered statistically significant. Nine RCTs with 540 patients were included in this review. Meta-analysis showed that leukocyte-poor platelet-rich plasma in significantly reduced retear rate in rotator cuff repair [RR=0.56 95% CI (0.42, 0.75); P<0.05), and in clinical results, the constant score [MD=3.67, 95% CI (1.62, 5.73); P=0.0005], UCLA score [MD=1.60, 95% CI (0.79, 2.42); P=0.0001], ASES score [MD=2.16, 95% CI (0.12, 4.20); P=0.04] were significantly improved. There was a significant result in favor of PRP for the Constant score [MD=-1.24, 95% CI (-1.50, -0.99); P<0.00001], while SST scores were not significantly different among all groups [MD=0.21, 95% CI (-0.21, 0.64); P=0.32]. In conclusion, leukocyte-poor platelet-rich plasma can improved the clinical function and reduced retear rate in arthroscopic rotator cuff repair. In contrast, the efficacy of leukocyte-rich platelet-rich plasma was not significantly improved with the exception of VAS score.