Can patients get better clinical outcomes by using PRP in rotator cuff repair: a meta-analysis of randomized controlled trials

INTRODUCTION: Platelet-rich plasma (PRP) has been effectively demonstrated to promote tendon-bone interface (TBI) healing by many in vivo and in vitro experiments. Clinically, PRP has been locally injected to improve post-surgery prognosis. However its efficacy in clinical is still discrepant since both positive and negative outcomes have been reported. This meta-analysis is to compare the clinical outcomes of rotator cuff repair with or without PRP using pooled data from included articles. EVIDENCE ACQUISITION: We searched the PubMed, Web of Science, EMBASE, and Cochrane Library electric databases and retrieved relevant articles. The most commonly used clinical score system: Constant Score, ASES, UCLA, SST, VAS scores (7 days postoperatively) and the integrity of rotator cuff were recorded and evaluated for the final meta- analysis. EVIDENCE SYNTHESIS: In total 8 articles were eligible for the final meta- analysis. Significant differences were indicated in Constant scores (P=0.02), SST (P=0.02) and VAS (P=0.03) between PRP group and non-PRP group. But no significant difference was found among the following comparisons: ASES (P=0.12), UCLA (P=0.85) and overall re-tear rate (P=0.92). For sub-group analysis, there was no significant difference in re-tear rate between PRP group and non-PRP group despite whether the follow-up time was less than 6 months or more than 6 months. Further, no significant difference was found in re-tear rate between PRP group and non-PRP group neither in large tear size sub-group comparison nor in non-large tear size sub-group comparison. CONCLUSIONS: Applying PRP within arthroscopic repair of rotator cuff can decrease postoperative pain. And it may also promote the functional recovery which should be supported with further researches. No better integrity of the rotator cuff could be identified by applying PRP according to current studies.