Cai You-zhi, Zhang Chi, Lin Xiang-jin
Department of Orthopedics and Center for Sport Medicine, The First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China.
Department of Orthopedics and Center for Sport Medicine, The First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China.
J Shoulder Elbow Surg. 2015 Dec;24(12):1852-9. doi: 10.1016/j.jse.2015.07.035. Epub 2015 Oct 9.
The use of platelet-rich plasma (PRP) is an innovative clinical therapy, especially in arthroscopic rotator cuff repair. The purpose of this study was to compare the clinical improvement and tendon-to-bone healing with and without PRP therapy in arthroscopic rotator cuff repair.
A systematic search was done in the major medical databases to evaluate the studies using PRP therapy (PRP+) or with no PRP (PRP-) for the treatment of patients with rotator cuff tears. We reviewed clinical scores such as the Constant score, the American Shoulder and Elbow Surgeons score, the University of California at Los Angeles (UCLA) Shoulder Rating Scale, the Simple Shoulder Test, and the failure-to-heal rate by magnetic resonance imaging between PRP+ and PRP- groups.
Five studies included in this review were used for a meta-analysis based on data availability. There were no statistically significant differences between PRP+ and PRP- groups for overall outcome scores (P > .05). However, the PRP+ group exhibited better healing rates postoperatively than the PRP- group (P = .03) in small/moderate full-thickness tears.
The use of PRP therapy in full-thickness rotator cuff repairs showed no statistically significant difference compared with no PRP therapy in clinical outcome scores, but the failure-to-heal rate was significantly decreased when PRP was used for treatment of small-to-moderately sized tears. PRP therapy may improve tendon-to-bone healing in patients with small or moderate rotator cuff tears.
富血小板血浆(PRP)的应用是一种创新的临床治疗方法,尤其在关节镜下肩袖修复术中。本研究的目的是比较在关节镜下肩袖修复术中使用PRP治疗与不使用PRP治疗的临床改善情况和肌腱与骨的愈合情况。
在主要医学数据库中进行系统检索,以评估使用PRP治疗(PRP+)或不使用PRP(PRP-)治疗肩袖撕裂患者的研究。我们回顾了PRP+组和PRP-组之间的临床评分,如Constant评分、美国肩肘外科医生评分、加利福尼亚大学洛杉矶分校(UCLA)肩评分量表、简单肩部测试,以及通过磁共振成像得出的不愈合率。
根据数据可用性,本综述纳入的五项研究用于荟萃分析。PRP+组和PRP-组的总体结果评分之间无统计学显著差异(P>.05)。然而,在小/中度全层撕裂中,PRP+组术后的愈合率高于PRP-组(P=.03)。
在全层肩袖修复术中使用PRP治疗与不使用PRP治疗相比临床结果评分无统计学显著差异,但当PRP用于治疗小至中度撕裂时不愈合率显著降低。PRP治疗可能改善小或中度肩袖撕裂患者的肌腱与骨愈合。