Rotator Cuff Repair With Platelet-Rich Plasma Is Associated With Lower Retear Rates When Compared With Rotator Cuff...

Platelet-rich plasma (PRP) and patch augmentation (PA) are 2 adjuncts that are used in the context of rotator cuff repair (RCR) to strengthen the repair construct and promote healing.

To systematically review the literature to compare the clinical efficacy of RCR with PA versus RCR with PRP.

Systematic review; Level of evidence, 2.

A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify Level 1 and 2 studies that compared the clinical efficacy of RCR alone with RCR with PRP or RCR with PA. The search phrase used was as follows: rotator cuff repair AND (patch OR augmentation OR bioinductive OR implant OR PRP OR platelet-rich plasma OR platelet-rich plasma). Patients were assessed based on the visual analog scale for pain, the Constant-Murley score, the American Shoulder and Elbow score, the University of California Los Angeles shoulder score, range of motion (ROM), and retear rates.

A total of 27 studies (Level 1 or 2) met the inclusion criteria, including 342 patients undergoing RCR with PA (mean age, 60 years) and 547 patients undergoing RCR with PRP (mean age, 58.1 years). The mean follow-up was 20.6 months in the PA group and 22.2 months in the PRP group. Among all patient-reported outcomes and ROM measures, there were no significant differences in weighted improvements between the 2 groups from pre- to postoperatively. However, patients undergoing RCR with PRP (13.1%) demonstrated significantly lower retear rates at the latest follow-up when compared with patients undergoing RCR with PA (18.4%) (P = .04).

Patients undergoing RCR with PRP may experience lower retear rates when compared with patients undergoing RCR with PA. Patients in both groups can be expected to experience similar improvements in both patient-reported and functional outcomes, although further randomized studies are needed to directly compare these 2 groups.