Paper # 117: Platelet-Rich Fibrin Matrix Augmentation for Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial

Abstract

Our study does not support the use of autologous PRFM for augmentation of a double row repair of a small or medium RC tear to improve the healing of the RC Following reinsertion on the humerus the rotator cuff (RC) has limited ability to heal. Growth factors augmentation has been proposed to be able to enhance healing in such procedure. To assess the efficacy and safety of the addition of growth factor augmentation during rotator cuff repair. Randomised controlled trial; Level of evidence, 1. Eighty-eight patients with a rotator cuff tear were randomly assigned by a computer-generated sequence to receive arthroscopic rotator cuff repair without (n=45) or with (n=43) augmentation with autologous platelet-rich fibrin matrix (PRFM). The primary endpoint was the post-operative difference in the Constant score between the 2 groups. The secondary endpoint was the integrity of the repaired rotator cuff, as evaluated by MRI. Analysis was on an intention to treat basis. All the patients completed follow-up at 16 months. There was no statistically significant difference in total Constant Score when comparing the results of arthroscopic repair of the 2 groups (95% confidence interval [CI], -3.43 - 3.9) (P=0.44). There was no statistically significant difference in MRI tendon score when comparing arthroscopic repair with or without PFRM (P=0.07). Our study does not support the use of autologous PRFM for augmentation of a double row repair of a small or medium RC tear to improve the healing of the RC. Our results are applicable to small and medium RC tears: it is possible that PRFM may be beneficial for large and massive RC tears. Also, given the heterogeneity of PRFM preparation products available on the market, it is possible that other preparations may be more effective.