Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
J Shoulder Elbow Surg. 2020 May;29(5):1059-1070. doi: 10.1016/j.jse.2020.01.084.
Platelet-rich plasma (PRP) has gained significant interest in recent years to potentially add biological augmentation of healing to surgical repairs of soft-tissue injuries. We sought to determine whether perioperative PRP injection influences the risk of failure following rotator cuff repair.
A systematic search was performed in the Embase and PubMed databases and identified 16 randomized controlled trials or prospective cohort studies (1045 participants) reporting rates of failure, defined as a subsequent tear on postoperative imaging, after rotator cuff repair with or without perioperative PRP administration. A random-effects meta-analysis of the included studies was performed to determine the pooled effect of PRP administration on the postoperative failure risk.
Among the 16 studies investigating rotator cuff repairs, PRP augmentation resulted in a 25% reduction in the risk of repair failure, with low heterogeneity among the included studies. A significant protective effect was seen for studies of only small to medium tears (7 studies) (P = .007) and studies including large or massive tears (9 studies) (P < .001).
Intraoperative PRP reduces the failure risk following rotator cuff repair and has a consistent effect regardless of tear size. However, because of the variability in PRP preparations, a specific recommendation cannot be made.
富含血小板的血浆（PRP）近年来引起了极大的兴趣，因为它有可能为软组织损伤的手术修复增加生物增强作用。我们旨在确定围手术期 PRP 注射是否会影响肩袖修复后的失败风险。
在 Embase 和 PubMed 数据库中进行了系统搜索，确定了 16 项随机对照试验或前瞻性队列研究（1045 名参与者），这些研究报告了肩袖修复后（术后影像学检查发现）的失败率，定义为随后发生的撕裂。对纳入的研究进行了随机效应荟萃分析，以确定 PRP 给药对术后失败风险的综合影响。
在 16 项研究中，PRP 增强剂可降低肩袖修复失败的风险 25%，且纳入的研究之间异质性较低。仅对小至中型撕裂（7 项研究）（P =.007）和包括大或巨大撕裂（9 项研究）（P <.001）的研究有显著的保护作用。
术中 PRP 可降低肩袖修复后的失败风险，并且无论撕裂大小，其效果一致。然而，由于 PRP 制剂的可变性，目前无法做出具体推荐。
