Platelet Rich Plasma as a Treatment Method for Rotator Cuff Tears
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MEDICINE
Platelet Rich Plasma as a Treatment Method for Rotator Cuff Tears Jack Hitchen 1 & Nicholas M. Wragg 2,3 & Maryam Shariatzadeh 2 & Samantha L. Wilson 2 Accepted: 28 August 2020 # The Author(s) 2020
Abstract The prevalence of the rotator cuff (RC) tears is ~ 21% in the general population, with higher incidences in individuals over 50. Irrespective of surgical repair techniques employed, re-tear rates are alarmingly high, indicating the need for improvement to the current treatment methods. A method that has recently increased in popularity is the administration of platelet-rich-plasma (PRP), as it has been proposed to significantly encourage and improve healing in a plethora of musculoskeletal tissues, although experimental conditions and results are often variable. This review aims to critically evaluate current literature concerning the use of PRP, specifically for the treatment of RC tears. There are ongoing conflicts debating the effectiveness of PRP to treat RC tears; with literature both in favour and against its use either having profound methodological weaknesses and/or limited applicability to most individuals with RC tears. There are numerous factors that may influence effectiveness, including the subgroup of patients studied and the timing and method of PRP delivery. Thus, in order to ascertain the clinical effectiveness of PRP for RC tears, the preparation protocol and composition of PRP must be standardised, so an accurate assessment and comparisons can be undertaken. Prior to clinical realisation, there is a requirement for a defined, standardised, quality-controlled protocol/procedure considering composition/formulation (of PRP); injury severity, dosage, frequency, timings, controls used, patient group, and rehabilitation programmes. Nevertheless, it is concluded that the initial step to aid the progression of PRP to treat RC tears is to standardise its preparation and delivery. Keywords Musculoskeletal injury . Platelet-rich plasma . Standardisation . Re-tear . Rotator cuff tear
Introduction Rotator cuff (RC) tears (Fig. 1) are one of the most common causes of shoulder pain, usually leading to difficulty sleeping and poor function [1–3]. The prevalence of RC tears is approximately 21% in the general population, which increases with age [4–7]; with considerably more tears sustained by This article is part of the Topical Collection on Medicine * Samantha L. Wilson [email protected] 1
National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire LE11 3TU, UK
2
Centre for Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough, Leicestershire LE11 3TU, UK
3
School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University, Keele, Stoke-on-Trent, Staffordshire ST4 7QB, UK
individuals aged 50 and older [8]. RC tear risk factors include degenerative changes to the tendon, traumatic
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