Efficacy and clinical outcomes of platelet-rich plasma for arthroscopic repair rotator cuff tears: a meta-analysis

Background: Platelet-rich plasma (PRP) is used as an innovative clinical therapy, especially for arthroscopic rotator cuff repair. The current literature about PRP for arthroscopic repair rotator cuff tears provides ample but inconsistent data. The purpose of our meta-analysis was to appraise the efficacy and clinical outcomes of PRP use in patients which undergoing arthroscopic rotator cuff repair. Material and method: We carefully searched the Cochrane Library, PubMed, Web of Science, Google Scholar and EMBASE major medical databases for all possible randomized controlled trials which comparing clinical outcomes of arthroscopic rotator cuff repair with or without PRP. Two reviewers selected all studies for inclusion, then assessed methodologic quality of all articles, finally extracted data. Data included outcome scores and re-tears diagnosed with imaging studies. Dichotomous variables were all presented as risk ratios (RRs) with their 95% confidence intervals (CIs), also continuous data were all measured as mean differences with their 95% CIs too. Results: Fifteen randomized controlled trials about PRR use in arthroscopic rotator cuff repair were included in our study, with the patient number ranging from 28 to 88. For all included studies overall methodological quality was high enough. Random-effects analysis showed that the differences were not significant between the PRP and Placebogroups in final re-tear rate (RR, 0.65; 95% CI, 0.40 to 1.06; P=0.08), Constant Scale (WMD, 2.49, 95% CI, -1.58 to 6.57; P=0.23), and University of California at Los Angeles (UCLA) score (WMD, 0.92; 95% CI, -1.29 to 3.13; P=0.41). Conclusions: Our study does not support the use of PRP in arthroscopic repair of full thickness rotator cuff tear, because the re-tear rates and clinical efficacy weresimilar when compared with that of no use PRP. Level of Evidence: Level II, meta-analysis of Level I and Level II studies.