Platelet-rich plasma supplementation in arthroscopic repair of full-thickness rotator cuff tears: a randomized clinical trial.

Abstract

Results on the effectiveness of PRP supplementation in arthroscopic rotator cuff repair are conflicting, making it difficult to draw definitive conclusions. This was a prospective, randomized, and double-blind study with two groups of 20 patients each (PRP group and control group). Degenerative supraspinatus full-thickness tears grade C2-C3 were subjected to arthroscopic repair; PRP supplementation was given to patients in the PRP group. The outcomes were assessed by DASH, Constant scales, and ultrasound before and 6months after surgery. Pain measured by VAS was evaluated preoperatively and 7 and 30days after surgery. The two groups did not differ significantly by age, sex, and dominance of the affected side. In all surgical procedures, a long head of the biceps tenotomy and single-row repair were performed. The preoperative VAS was 5.6±2.4 in PRP group and 6.4±1.5 in the control group (p>0.05). The group supplemented with PRP reported a VAS significantly better in the first week (2.5±1.9 vs 5.3±2.1, p<0.05) and during the first month after surgery (1.5±1.0 vs 3.2±1.7, p<0.05) compared to the control group. The preoperative Constant and DASH scores were 39.95±12 and 51±15.2, respectively, in the PRP group and 41±11 (p>0.05) and 45±12.6 (p>0.05) in the control group. The average Constant score improved significantly after 6months to 81±11.2 (p<0.05) in the PRP group and 78.5±9 (p<0.05) in the control group. No differences were noted between the two groups (p>0.05). The DASH score after 6months was 17.4±8 (p<0.05) for the treatment group (the PRP group) and 21±8.4 (p<0.05) for the control group. No statistically significant differences were found as regards the DASH score in the two groups after 6months (p>0.05). The two groups showed no differences in the ultrasound evaluation after 6months either. No re-ruptures occurred in either group. PRP leads to a reduction in pain during a short-term follow-up. Pain reduction allows for a more rapid recovery of mobilization and improvement in functionality. Randomized controlled trial, Level of evidence, 1.