Arthroscopic Surgery Combined With Platelet-Rich Plasma Does Not Significantly Improve Pain, Function, Complications, and Retear Rate Compared With Arthroscopic Surgery Alone for Full-Thickness Rotator Cuff Tears: A Systematic Review and Meta-analysis

• Published in: Arthroscopy Vol. 41; no. 2; pp. 289 - 301
• Main Authors: Xue, Xiali, Xiao, Chongyao, Song, Qingfa, Kuati, Amila, Zhou, Xuchang, Cui, Guoqing
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2025
• Subjects: Arthroscopy - adverse effects; Arthroscopy - methods; Combined Modality Therapy; Humans; Pain, Postoperative; Platelet-Rich Plasma; Postoperative Complications - prevention & control; Randomized Controlled Trials as Topic; Rotator Cuff Injuries - surgery; Rotator Cuff Injuries - therapy; Treatment Outcome
• ISSN: 0749-8063; 1526-3231; 1526-3231
• DOI: 10.1016/j.arthro.2024.03.024

To evaluate the effectiveness and safety of arthroscopic surgery combined with platelet-rich plasma (PRP) compared with arthroscopic surgery alone in the treatment of patients with full-thickness rotator cuff tears. The Cochrane Library, PubMed, Embase, Scopus, EBSCO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database were systematically searched from inception to November 2023. Subject words combined with free words were used to collect randomized controlled trials focusing on arthroscopic surgery combined with PRP in the treatment of full-thickness rotator cuff tears. The assessment of evidence quality employed the Cochrane Collaboration risk of bias tool, and data analysis was performed using RevMan 5.3 software. A total of 9 studies with 537 patients were included. The meta-analysis revealed that compared with the arthroscopic surgery alone group, the summary result of University of California Los Angeles score scores in the arthroscopic combined with PRP group was (mean difference [MD] = 1.08, 95% confidence interval [CI] 0.19∼1.97, P = .02), subgroup analysis of surgical suture method visual analog scale (VAS) single-row (MD = –1.00, 95% CI –1.50 to –0.50, P < .0001), VAS double-row (MD = –0.10, 95% CI –0.17 to –0.02, P = .02), and Constant-Murley score single-row (MD = 3.49, 95% CI 0.32∼6.66, P = .03), the difference was statistically significant, and the differences in VAS, Constant-Murley score, and Quick Disabilities of the Arm, Shoulder and Hand, complications, and retear rate were not statistically significant. Patients undergoing arthroscopic repair combined with PRP treatment showed no difference in pain, function, complications, and retear rate compared with those treated with arthroscopic surgery alone. Level II, systematic review and meta-analysis of Level I and II evidence studies.