Do Postoperative Platelet-Rich Plasma Injections Accelerate Early Tendon Healing and Functional Recovery After Arthroscopic Supraspinatus Repair?: A Randomized Controlled Trial

• Published in: The American journal of sports medicine 2015-06, Vol.43 (6), p.1430-1437
• Main Authors: Wang, Allan, McCann, Philip, Colliver, Jess, Koh, Eamon, Ackland, Timothy, Joss, Brendan, Zheng, Minghao, Breidahl, Bill
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthroplasty - methods; Arthroscopy; Arthroscopy - methods; Bones; Clinical outcomes; Clinical trials; Female; Humans; Injections, Intralesional; Magnetic Resonance Imaging; Male; Middle Aged; Platelet-Rich Plasma; Postoperative Care - methods; Range of Motion, Articular - physiology; Recovery of Function - physiology; Rotator Cuff - physiology; Rotator Cuff - surgery; Rotator Cuff Injuries; Rupture - surgery; Shoulder Joint - surgery; Surgical outcomes; Tendon Injuries - physiopathology; Tendon Injuries - rehabilitation; Tendon Injuries - surgery; Tendons; Treatment Outcome; Ultrasonography, Interventional; Wound Healing - physiology
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546515572602

Background: Tendon-bone healing after rotator cuff repair directly correlates with a successful outcome. Biological therapies that elevate local growth-factor concentrations may potentiate healing after surgery. Purpose: To ascertain whether postoperative and repeated application of platelet-rich plasma (PRP) to the tendon repair site improves early tendon healing and enhances early functional recovery after double-row arthroscopic supraspinatus repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 60 patients underwent arthroscopic double-row supraspinatus tendon repair. After randomization, half the patients received 2 ultrasound-guided injections of PRP to the repair site at postoperative days 7 and 14. Early structural healing was assessed with MRI at 16 weeks, and cuff appearances were graded according to the Sugaya classification. Functional scores were recorded with the Oxford Shoulder Score; Quick Disability of the Arm, Shoulder and Hand; visual analog scale for pain; and Short Form–12 quality-of-life score both preoperatively and at postoperative weeks 6, 12, and 16; isokinetic strength and active range of motion were measured at 16 weeks. Results: PRP treatment did not improve early functional recovery, range of motion, or strength or influence pain scores at any time point after arthroscopic supraspinatus repair. There was no difference in structural integrity of the supraspinatus repair on MRI between the PRP group (0% full-thickness retear; 23% partial tear; 77% intact) and the control group (7% full-thickness retear; 23% partial tear; 70% intact) at 16 weeks postoperatively (P = .35). Conclusion: After arthroscopic supraspinatus tendon repair, image-guided PRP treatment on 2 occasions does not improve early tendon-bone healing or functional recovery.