Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis
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(2019) 14:183
SYSTEMATIC REVIEW
Open Access
Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials Changxu Han1†, Yuyan Na1†, Yong Zhu2, Lingyue Kong1, Tu Eerdun1, Xuejun Yang2* and Yizhong Ren1*
Abstract Background: Recently, many authors have reported the effects of platelet-rich plasma (PRP) on rotator cuff repair. Whether PRP treatment during arthroscopic rotator cuff repair improves tendon healing rates or restores full function remains unknown. The purpose of this meta-analysis was to evaluate the clinical improvement and radiological outcomes of PRP treatment in patients undergoing arthroscopic rotator cuff repair. Methods: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched. The study included only level 1 or 2 randomized controlled trials (RCTs) that compared the injection of platelet-rich plasma or platelet-rich fibrin matrix. The methodological quality of the trials was assessed using the Cochrane Handbook for Systematic Reviews of Interventions, 5.3. Continuous variables were analysed using the weighted mean difference, and categorical variables were assessed using relative risks. P < 0.05 was considered statistically significant. Results: The meta-analysis revealed a lower retear rate following PRP treatment than that following the control method (mean difference, 1.10; 95% CI, 1.03 to 1.18; P = 0.004). Constant shoulder scores improved with PRP (mean difference, 2.31; 95% CI, 1.02 to 3.61; P = 0.0005). PRP treatment also resulted in higher UCLA scores (mean difference, 0.98; 95% CI, 0.27 to 1.69; P = 0.007), and simple shoulder test scores were improved (mean difference, 0.43; 95% CI, 0.11 to 0.75; P = 0.008). Finally, lower visual analogue scale scores were observed with PRP augmentation (mean difference, − 0.35; 95% CI, − 0.57 to − 0.13; P = 0.002). Conclusions: The current systematic review and meta-analysis reveals that PRP treatment with arthroscopic repair of rotator cuff tears decreases the retear rate and improves the clinical outcomes. Systematic review registration: PROSPERO CRD42016048416 Keywords: Platelet-rich plasma, Rotator cuff, Meta-analysis, Arthroscopic
* Correspondence: [email protected]; [email protected] † Changxu Han and Yuyan Na contributed equally to this work. 2 Department of Spinal Surgery, The Second Hospital of Inner Mongolia Medical University, No. 1 Yingfang Street, Huimin District, Hohhot 010000, Inner Mongolia Autonomous Region, China 1 Department of Arthroscopy and Sports Medicine, The Second Affiliated Hospital of Inner Mongolia Medical University, No. 1 Yingfang Street, Huimin District, Hohhot 010000, Inner Mongolia Autonomous Region, China © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropri
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