PRP Use During Rotator Cuff Repair Surgery

Malavolta et al. Clinical and structural evaluations of rotator cuff repair with and without added platelet-rich plasma at 5 year follow up. 2018;46(13):3134-3141.

A recent paper from the American Journal of Sports Medicine compared the clinical and structural outcome of rotator cuff repair surgery with and without added platelet-rich plasma.

This study randomized patients to receiving, or not receiving PRP at the time of rotator cuff repair surgery.  The purpose of the study was to test the hypothesis that functional and structural results would be better following PRP administration at the time of rotator cuff surgery.   The authors found that there was no evidence of better clinical or structural results at five years following surgery to repair the rotator cuff tendon.  None of the clinical assessments at 6, 12, and 24 months in either group (PRP vs non-PRP) produced statistically significant differences.  Similarly, the re-tear rate, or non-healing rate, between the PRP group and non-PRP group demonstrated no significant differences.   This may lead one to conclude that the added expense, cost, and time of PRP treatment at the time of rotator cuff repair surgery is not useful.  This may in fact be the case.  If PRP continues to be promoted and used in the above manner, future studies will be needed to ensure that there is adequate study power to truly detect a difference between study groups.  A finding of no difference does not always mean that a difference does not exist.  A finding of no difference may mean that the study was not powerful enough to detect a difference.  Power relates to the number of patients in a study group, the size of the difference being detected and variability within the group.  Moreover, one may also need to examine how PRP is delivered – should it be placed as an injection, imbedded in a patch, incorporated into suture or bone anchors.  All of  these factors may play a role .  Nevertheless, at present there does not appear to be sufficient evidence to promote the use of PRP in conjunction with rotator cuff repair surgery.  If you have questions about the use of biological treatment such as PRP for shoulder problems such as rotator cuff tears and rotator cuff repair surgery, please speak with a shoulder specialist at The Shoulder Clinic of Idaho.

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