Platelet Rich Plasma In Arthroscopic Rotator Cuff Repair: A Prospective Rct Study, 2-Year Follow-Up

Pietro Randelli, Paolo Arrigoni, Vincenza Ragone, Alberto Aliprandi, Paolo Cabitza

Research output: Contribution to journalArticle

Abstract

Hypothesis: Local application of autologous platelet rich plasma (PRP) improves tendon healing in patients undergoing arthroscopic rotator cuff repair. Study design: Prospective, randomized, controlled, double blind study; considering an alpha level of 5%, a power of 80%, 22 patients for group are needed. Materials and methods: Fifty-three patients who underwent shoulder arthroscopy for the repair of a complete rotator cuff tear were randomly divided into 2 groups, using a block randomization procedure. A treatment group (N = 26) consisted of those who received an intraoperative application of PRP in combination with an autologous thrombin component. A control group (N = 27) consisted of those who did not receive that treatment. Patients were evaluated with validated outcome scores. A magnetic resonance image (MRI) was performed in all cases at more than 1 year post-op. All patients had the same accelerated rehabilitation protocol. Results: The 2 groups were homogeneous. The pain score in the treatment group was lower than the control group at 3, 7, 14, and 30 days after surgery (P <.05). On the Simple Shoulder Test (SST), University of California (UCLA), and Constant scores, strength in external rotation, as measured by a dynamometer, were significantly higher in the treatment group than the control group at 3 months after surgery (strength in external rotation [SER]: 3 ± 1.6 vs 2.1 ± 1.3 kg; SST: 8.9 ± 2.2 vs 7.1 ± 2.7; UCLA: 26.9 ± 3 vs 24.2 ± 4.9; Constant: 65 ± 9 vs 57.8 ± 11; P <.05). There was no difference between the 2 groups after 6, 12, and 24 months. The follow-up MRI showed no significant difference in the healing rate of the rotator cuff tear. In the subgroup of grade 1 and 2 tears, with less retraction, SER in the PRP group was significant higher at 3, 6, 12, and 24 months postoperative (P <.05). Conclusion: The results of our study showed autologous PRP reduced pain in the first postoperative months. The long-term results of subgroups of grade 1 and 2 tears suggest that PRP positively affected cuff rotator healing.

Original languageEnglish
Pages (from-to)518-528
Number of pages11
JournalJournal of Shoulder and Elbow Surgery
Volume20
Issue number4
DOIs
Publication statusPublished - Jun 2011

Fingerprint

Platelet-Rich Plasma
Rotator Cuff
Prospective Studies
Tears
Control Groups
Magnetic Resonance Spectroscopy
Pain
Arthroscopy
Therapeutics
Random Allocation
Ambulatory Surgical Procedures
Double-Blind Method
Thrombin
Tendons
Rehabilitation

Keywords

  • Arthroscopy
  • Growth factors
  • Level I
  • Platelet rich plasma
  • Randomized Controlled Trial
  • Rotator cuff repair
  • Shoulder
  • Treatment Study

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Platelet Rich Plasma In Arthroscopic Rotator Cuff Repair : A Prospective Rct Study, 2-Year Follow-Up. / Randelli, Pietro; Arrigoni, Paolo; Ragone, Vincenza; Aliprandi, Alberto; Cabitza, Paolo.

In: Journal of Shoulder and Elbow Surgery, Vol. 20, No. 4, 06.2011, p. 518-528.

Research output: Contribution to journalArticle

Randelli, Pietro ; Arrigoni, Paolo ; Ragone, Vincenza ; Aliprandi, Alberto ; Cabitza, Paolo. / Platelet Rich Plasma In Arthroscopic Rotator Cuff Repair : A Prospective Rct Study, 2-Year Follow-Up. In: Journal of Shoulder and Elbow Surgery. 2011 ; Vol. 20, No. 4. pp. 518-528.
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abstract = "Hypothesis: Local application of autologous platelet rich plasma (PRP) improves tendon healing in patients undergoing arthroscopic rotator cuff repair. Study design: Prospective, randomized, controlled, double blind study; considering an alpha level of 5{\%}, a power of 80{\%}, 22 patients for group are needed. Materials and methods: Fifty-three patients who underwent shoulder arthroscopy for the repair of a complete rotator cuff tear were randomly divided into 2 groups, using a block randomization procedure. A treatment group (N = 26) consisted of those who received an intraoperative application of PRP in combination with an autologous thrombin component. A control group (N = 27) consisted of those who did not receive that treatment. Patients were evaluated with validated outcome scores. A magnetic resonance image (MRI) was performed in all cases at more than 1 year post-op. All patients had the same accelerated rehabilitation protocol. Results: The 2 groups were homogeneous. The pain score in the treatment group was lower than the control group at 3, 7, 14, and 30 days after surgery (P <.05). On the Simple Shoulder Test (SST), University of California (UCLA), and Constant scores, strength in external rotation, as measured by a dynamometer, were significantly higher in the treatment group than the control group at 3 months after surgery (strength in external rotation [SER]: 3 ± 1.6 vs 2.1 ± 1.3 kg; SST: 8.9 ± 2.2 vs 7.1 ± 2.7; UCLA: 26.9 ± 3 vs 24.2 ± 4.9; Constant: 65 ± 9 vs 57.8 ± 11; P <.05). There was no difference between the 2 groups after 6, 12, and 24 months. The follow-up MRI showed no significant difference in the healing rate of the rotator cuff tear. In the subgroup of grade 1 and 2 tears, with less retraction, SER in the PRP group was significant higher at 3, 6, 12, and 24 months postoperative (P <.05). Conclusion: The results of our study showed autologous PRP reduced pain in the first postoperative months. The long-term results of subgroups of grade 1 and 2 tears suggest that PRP positively affected cuff rotator healing.",
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N2 - Hypothesis: Local application of autologous platelet rich plasma (PRP) improves tendon healing in patients undergoing arthroscopic rotator cuff repair. Study design: Prospective, randomized, controlled, double blind study; considering an alpha level of 5%, a power of 80%, 22 patients for group are needed. Materials and methods: Fifty-three patients who underwent shoulder arthroscopy for the repair of a complete rotator cuff tear were randomly divided into 2 groups, using a block randomization procedure. A treatment group (N = 26) consisted of those who received an intraoperative application of PRP in combination with an autologous thrombin component. A control group (N = 27) consisted of those who did not receive that treatment. Patients were evaluated with validated outcome scores. A magnetic resonance image (MRI) was performed in all cases at more than 1 year post-op. All patients had the same accelerated rehabilitation protocol. Results: The 2 groups were homogeneous. The pain score in the treatment group was lower than the control group at 3, 7, 14, and 30 days after surgery (P <.05). On the Simple Shoulder Test (SST), University of California (UCLA), and Constant scores, strength in external rotation, as measured by a dynamometer, were significantly higher in the treatment group than the control group at 3 months after surgery (strength in external rotation [SER]: 3 ± 1.6 vs 2.1 ± 1.3 kg; SST: 8.9 ± 2.2 vs 7.1 ± 2.7; UCLA: 26.9 ± 3 vs 24.2 ± 4.9; Constant: 65 ± 9 vs 57.8 ± 11; P <.05). There was no difference between the 2 groups after 6, 12, and 24 months. The follow-up MRI showed no significant difference in the healing rate of the rotator cuff tear. In the subgroup of grade 1 and 2 tears, with less retraction, SER in the PRP group was significant higher at 3, 6, 12, and 24 months postoperative (P <.05). Conclusion: The results of our study showed autologous PRP reduced pain in the first postoperative months. The long-term results of subgroups of grade 1 and 2 tears suggest that PRP positively affected cuff rotator healing.

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