scholarly journals The Role of Platelet Rich Plasma (PRP) and Other Biologics for Rotator Cuff Repair

2016 ◽  
Vol 10 (1) ◽  
pp. 309-314 ◽  
Author(s):  
Joshua A. Greenspoon ◽  
Samuel G. Moulton ◽  
Peter J. Millett ◽  
Maximilian Petri
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Animal Studies ◽  
Platelet Rich Plasma ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Targeted Drug ◽  
Cuff Repair

Background: Surgical treatment of rotator cuff tears has consistently demonstrated good clinical and functional outcomes. However, in some cases, the rotator cuff fails to heal. While improvements in rotator cuff constructs and biomechanics have been made, the role of biologics to aid healing is currently being investigated. Methods: A selective literature search was performed and personal surgical experiences are reported. Results: Biologic augmentation of rotator cuff repairs can for example be performed wtableith platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs). Clinical results on PRP application have been controversial. Application of MSCs has shown promise in animal studies, but clinical data on its effectiveness is presently lacking. The role of Matrix Metalloproteinase (MMP) inhibitors is another interesting field for potential targeted drug therapy after rotator cuff repair. Conclusions: Large randomized clinical studies need to confirm the benefit of these approaches, in order to eventually lower retear rates and improve clinical outcomes after rotator cuff repair.

Freeze-dried chitosan-platelet-rich plasma implants improve supraspinatus tendon attachment in a transosseous rotator cuff repair model in the rabbit

2018 ◽  
Vol 33 (6) ◽  
pp. 792-807 ◽  
Author(s):  
Gabrielle Deprés-Tremblay ◽  
Anik Chevrier ◽  
Martyn Snow ◽  
Scott Rodeo ◽  
Michael D Buschmann
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Rabbit Model ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Polymorphonuclear Cells ◽  
Post Surgery ◽  
Freeze Dried ◽  
Cuff Repair

Rotator cuff tears result in shoulder pain, stiffness, weakness and loss of motion. After surgical repair, high failure rates have been reported based on objective imaging and it is recognized that current surgical treatments need improvement. The aim of the study was to assess whether implants composed of freeze-dried chitosan (CS) solubilized in autologous platelet-rich plasma (PRP) can improve rotator cuff repair in a rabbit model. Complete tears were created bilaterally in the supraspinatus tendon of New Zealand White rabbits ( n = 4 in a pilot feasibility study followed by n = 13 in a larger efficacy study), which were repaired using transosseous suturing. On the treated side, CS-PRP implants were injected into the transosseous tunnels and the tendon itself, and healing was assessed histologically at time points ranging from one day to two months post-surgery. CS-PRP implants were resident within transosseous tunnels and adhered to tendon surfaces at one day post-surgery and induced recruitment of polymorphonuclear cells from 1 to 14 days. CS-PRP implants improved attachment of the supraspinatus tendon to the humeral head through increased bone remodelling at the greater tuberosity and also inhibited heterotopic ossification of the supraspinatus tendon at two months. In addition, the implants did not induce any detectable deleterious effects. This preliminary study provides the first evidence that CS-PRP implants could be effective in improving rotator cuff tendon attachment in a small animal model.

scholarly journals Lateral acromioplasty for correction of the critical shoulder angle

2020 ◽  
Vol 15 (3) ◽  
pp. 228-232
Author(s):  
Mark Tauber ◽  
Peter Habermeyer ◽  
Nikolaus Zumbansen ◽  
Frank Martetschläger
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Logical Consequence ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Critical Shoulder Angle ◽  
Cuff Repair ◽  
Shoulder Angle

Abstract The critical shoulder angle (CSA) was introduced as a radiological parameter associated with a higher incidence of rotator cuff tears. As a logical consequence, correcting the CSA together with rotator cuff repair should prevent re-tear and provide reliable and good clinical results. We present an all-arthroscopic technique resecting the lateral edge of the acromion (lateral acromioplasty) in order to reduce and correct the CSA after preoperative planning. Preliminary results from 20 patients with an average age of 62 years after rotator cuff repair are reported showing good clinical outcome with a Constant score of 88 points and no re-tear after an average follow-up of 16 months. The CSA was reduced from 39.7° to 32.1°. Previous concerns regarding weakening of the deltoid origin were not confirmed and there were no complications linked to lateral acromioplasty.

The Role of Platelet-Rich Plasma in Rotator Cuff Repair

2013 ◽  
pp. 497-502
Author(s):  
Pietro Randelli ◽  
Vincenza Ragone ◽  
Paolo Cabitza
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Cuff Repair

The Efficacy of Platelet-Rich Plasma and Platelet-Rich Fibrin in Arthroscopic Rotator Cuff Repair: A Meta-analysis of Randomized Controlled Trials

2018 ◽  
Vol 47 (3) ◽  
pp. 753-761 ◽  
Author(s):  
Eoghan T. Hurley ◽  
Daren Lim Fat ◽  
Cathal J. Moran ◽  
Hannan Mullett
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Platelet Rich Plasma ◽  
Constant Score ◽  
Meta Analysis ◽  
Tendon Healing ◽  
Randomized Controlled ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Basic science studies suggest that platelet-rich therapies have a positive effect on tendon repair. However, the clinical evidence is conflicted on whether this translates to increased tendon healing and improved functional outcomes. Purpose: To perform a systematic review of randomized controlled trials (RCTs) in the literature to ascertain whether platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) improved patient outcomes in arthroscopic rotator cuff repair. Study Design: Meta-analysis. Methods: Two independent reviewers performed the literature search based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a third author resolving any discrepancies. RCTs comparing PRP or PRF to a control in rotator cuff repair were included. Quality of evidence was assessed using the Jadad score. Clinical outcomes were compared using the risk ratio for dichotomous variables and the mean difference for continuous variables. A P value <.05 was deemed statistically significant. Results: Eighteen RCTs with 1147 patients were included in this review. PRP resulted in significantly decreased rates of incomplete tendon healing for all tears combined (17.2% vs 30.5%, respectively; P < .05), incomplete tendon healing in small-medium tears (22.4% vs 38.3%, respectively; P < .05), and incomplete tendon healing in medium-large tears (12.3% vs 30.5%, respectively; P < .05) compared to the control. There was a significant result in favor of PRP for the Constant score (85.6 vs 83.1, respectively; P < .05) and the visual analog scale score for pain at 30 days postoperatively (2.9 vs 4.3, respectively; P < .05) and at final follow-up (1.2 vs 1.4, respectively; P < .05) compared to the control. PRF did not result in a significantly decreased rate of incomplete tendon healing for all tears combined (23.0% vs 24.6%, respectively; P = .74) or an improved Constant score (80.8 vs 79.8, respectively; P = .27) compared to the control. PRF resulted in a significantly longer operation time (99.1 vs 83.3 minutes, respectively; P< .05) compared to the control. Conclusion: The current evidence indicates that the use of PRP in rotator cuff repair results in improved healing rates, pain levels, and functional outcomes. In contrast, PRF has been shown to have no benefit in improving tendon healing rates or functional outcomes.

The Role of Platelet-Rich Plasma and Growth Factors in Rotator Cuff Repair

2019 ◽  
pp. 33-42
Author(s):  
Laura A. Vogel ◽  
Santiago Rodriguez ◽  
Mary Beth R. McCarthy ◽  
Andreas Voss ◽  
Augustus D. Mazzocca
Keyword(s):  
Growth Factors ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Cuff Repair

scholarly journals Systematic Review of Literature on the Efficiency of Using PRP in Arthroscopic Rotator Cuff Repair

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
T M Samy ◽  
A H Khater ◽  
A K M Ahmed
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Bone Repair ◽  
Platelet Rich Plasma ◽  
Tendon Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Rotator cuff tears are one of the most common shoulder problems and the incidence of this condition is increasing along with an aging population. Despite satisfactory results for rotator cuff repair the quality and speed of healing remain problematic. Several studies have demonstrated that native tendon-bone insertions were not restored after tendon to bone repair. Healing of repaired tendons occurred via fibrous scar tissue formation rather than via the regeneration of a histologically normal insertion, and thus repaired tendons have inferior mechanical properties and are more susceptible to retear. Presumably, this is the most significant reason that account for tendon repair failure. Despite recent biomechanical advances in fixation, rates of retear are still high. Tendons consume little energy, and as a consequence healing is slow after injury. Increasing the speed of healing would allow earlier return to work, sport, and activities of daily living, which would be helpful for both the elite athlete and general public. Platelet rich plasma was first popularized in maxillofacial and plastic surgery, but now is thought to enhance and accelerate the repair and regeneration of a variety of tissues, such as bone, cartilage, tendon, ligament, and muscle. This systematic review reporting the effect of PRP after arthroscopic rotator cuff repair.

scholarly journals Should We be Routinely Performing Arthroscopic Subacromial Decompression During Rotator Cuff Repair (RCR)?

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sachin Kumar ◽  
Rajiv Gogna ◽  
Daniel Morris, ◽  
Amol Tambe
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Nonoperative Management ◽  
Relevant Literature ◽  
Rotator Cuff Tears ◽  
Subacromial Decompression ◽  
Arthroscopic Rotator Cuff ◽  
Arthroscopic Subacromial Decompression ◽  
Cuff Repair

Symptomatic rotator cuff tears cause pain and impaired function. Arthroscopic rotator cuff repair is an established treatment when nonoperative management fails. However, debate exists regarding the requirement of concurrent subacromial decompression. This review aims to answer pertinent questions and outline relevant literature in the role of arthroscopic subacromial decompression in rotator cuff repair. Keywords: Decompression, Cuff, Arthroscopic, Repair.

Sign in / Sign up

Export Citation Format

Share Document