Saturday, April 2, 2011

PRP platelet rich plasma another negative study.

This is the second negative study I have seen recently on the use of PRP my opinion is still mixed and I plan on doing a full review of articles and other physicians opinions soon but my gut instinct is that it does work and the problem is that we have various methods of preparation and application.

Other study

Platelet-Rich Plasma Augmentation for Arthroscopic Rotator Cuff Repair

A Randomized Controlled Trial

Roberto Castricini, MD*,
Umile Giuseppe Longo, MD, MSc†,
Massimo De Benedetto, MD‡,
Nicola Panfoli, MD*,
Piergiorgio Pirani, MD‡,
Raul Zini, MD‡,
Nicola Maffulli, MD, MS, PhD, FRCS(Orth)§‖ and
Vincenzo Denaro, MD†

+Author Affiliations

^*Department of Orthopaedic and Trauma Surgery, Ospedale Civile, Jesi, Italy
^†Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Rome, Italy
^‡Department of Orthopaedic and Trauma Surgery, Villa Maria Cecilia Hospital–GVM Care & Research, Cotignola-Ravenna, Italy
^‖Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, England
Investigation performed at the Department of Orthopaedic and Trauma Surgery, Ospedale Civile, Jesi, Italy

§Nicola Maffulli, MD, MS, PhD, FRCS(Orth), Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England (e-mail:n.maffulli@qmul.ac.uk).

Abstract

Background: After reinsertion on the humerus, the rotator cuff has limited ability to heal. Growth factor augmentation has been proposed to enhance healing in such procedure.

Purpose: This study was conducted to assess the efficacy and safety of growth factor augmentation during rotator cuff repair.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: Eighty-eight patients with a rotator cuff tear were randomly assigned by a computer-generated sequence to receive arthroscopic rotator cuff repair without (n = 45) or with (n = 43) augmentation with autologous platelet-rich fibrin matrix (PRFM). The primary end point was the postoperative difference in the Constant score between the 2 groups. The secondary end point was the integrity of the repaired rotator cuff, as evaluated by magnetic resonance imaging. Analysis was on an intention-to-treat basis.

Results: All the patients completed follow-up at 16 months. There was no statistically significant difference in total Constant score when comparing the results of arthroscopic repair of the 2 groups (95% confidence interval, −3.43 to 3.9) (P = .44). There was no statistically significant difference in magnetic resonance imaging tendon score when comparing arthroscopic repair with or without PRFM (P = .07).

Conclusion: Our study does not support the use of autologous PRFM for augmentation of a double-row repair of a small or medium rotator cuff tear to improve the healing of the rotator cuff. Our results are applicable to small and medium rotator cuff tears; it is possible that PRFM may be beneficial for large and massive rotator cuff tears. Also, given the heterogeneity of PRFM preparation products available on the market, it is possible that other preparations may be more effective.