Editorial Commentary: Platelet-Rich Plasma Reduces Retear Rates Following Rotator Cuff Repair but Does Not Improve Clinical Outcomes.

Abstract

Platelet-rich plasma (PRP) is a novel biologic treatment in orthopaedic sports medicine that may enhance surgical repairs and improve clinical and functional outcomes. Studies investigating the effect of PRP on shoulder rotator cuff healing, clinical outcomes, and retear rates suggest that PRP has no effect on outcome and healing but potentially reduces retear rates. However, study quality is compromised by low samples sizes, inadequate randomization protocols, and heterogeneity. In addition, other factors influence outcomes and could cause bias when collecting data. PRP preparation varies among studies, and a variety of patient factors such as smoking; comorbidity; rotator cuff tear size, configuration, and grade; and functional demands are difficult to control even if a randomized study protocol is undertaken. Until there are reliable and valid data available, the use of PRP in rotator cuff repair is not strongly supported and is at the discretion of the treating surgeon. The current evidence shows the superiority of PRP over hyaluronic acid and corticosteroids, and there is promise that PRP could be a useful adjunct promoting rotator cuff healing following surgical repair.