PMID- 25450417
OWN - NLM
STAT- MEDLINE
DCOM- 20150609
LR  - 20220408
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 31
IP  - 2
DP  - 2015 Feb
TI  - Clinical and structural outcomes after arthroscopic repair of full-thickness 
      rotator cuff tears with and without platelet-rich product supplementation: a 
      meta-analysis and meta-regression.
PG  - 306-20
LID - S0749-8063(14)00795-6 [pii]
LID - 10.1016/j.arthro.2014.09.007 [doi]
AB  - PURPOSE: The purpose of this study was to perform a systematic review, 
      meta-analysis, and meta-regression of all Level I and Level II studies comparing 
      the clinical or structural outcomes, or both, after rotator cuff repair with and 
      without platelet-rich product (PRP) supplementation. METHODS: A literature search 
      of the PubMed and EMBASE databases was performed to identify all Level I or II 
      studies comparing the clinical or structural outcomes, or both, after 
      arthroscopic repair of full-thickness rotator cuff tears with (PRP+ group) and 
      without (PRP- group) PRP supplementation. Data included outcome scores (American 
      Shoulder and Elbow Surgeons [ASES], University of California Los Angeles [UCLA], 
      Constant, Simple Shoulder Test [SST] and visual analog scale [VAS] scores) and 
      retears diagnosed with imaging studies. Meta-analyses compared preoperative, 
      postoperative, and gain in outcome scores and relative risk ratios for retears. 
      Meta-regression compared the effect of PRP treatment on outcome scores and retear 
      rates according to 6 covariates. Minimum effect sizes that were detectable with 
      80% power were also calculated for each study. RESULTS: Eleven studies were 
      included in this review and a maximum of 8 studies were used for meta-analyses 
      according to data availability. There were no statistically significant 
      differences between the PRP+ and PRP- groups for overall outcome scores or retear 
      rates (P > .05). Overall gain in the Constant score was decreased when liquid PRP 
      was injected over the tendon surface compared with PRP application at the 
      tendon-bone interface (-6.88 points v +0.78 points, respectively; P = .046); 
      however, this difference did not reach the previously reported minimum clinically 
      important difference (MCID) for Constant scores. When the initial tear size was 
      greater than 3 cm in anterior-posterior length, the PRP+ group exhibited 
      decreased retear rates after double-row repairs when compared with the PRP- group 
      (25.9% v 57.1%, respectively; P = .046). Sensitivity power analyses revealed that 
      most included studies were only powered to detect large differences in outcome 
      scores between groups. CONCLUSIONS: There were no statistically significant 
      differences in overall gain in outcome scores or retear rates between treatment 
      groups. Gain in Constant scores was significantly increased when PRPs were 
      applied at the tendon-bone interface when compared with application over the top 
      of the repaired tendon. Retear rates were significantly decreased when PRPs were 
      used for the treatment of tears greater than 3 cm in anterior-posterior length 
      using a double-row technique. Most of the included studies were only powered to 
      detect large differences in outcome scores between treatment groups. In addition, 
      an increased risk for selection, performance, and attrition biases was found. 
      LEVEL OF EVIDENCE: Level II, meta-analysis of Level I and Level II studies.
CI  - Copyright (c) 2015 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Warth, Ryan J
AU  - Warth RJ
AD  - Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
FAU - Dornan, Grant J
AU  - Dornan GJ
AD  - Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
FAU - James, Evan W
AU  - James EW
AD  - Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
FAU - Horan, Marilee P
AU  - Horan MP
AD  - Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
FAU - Millett, Peter J
AU  - Millett PJ
AD  - Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman 
      Clinic, Vail, Colorado, U.S.A.. Electronic address: 
      drmillett@thesteadmanclinic.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20141114
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2015 Apr;31(4):597-8. PMID: 25842229
CIN - Arthroscopy. 2015 Apr;31(4):598. PMID: 25842230
MH  - Arthroscopy
MH  - Humans
MH  - *Platelet-Rich Plasma
MH  - Rotator Cuff/physiopathology/*surgery
MH  - Rotator Cuff Injuries
MH  - Rupture
MH  - Tendon Injuries/physiopathology/*surgery/therapy
MH  - Treatment Outcome
MH  - Wound Healing
EDAT- 2014/12/03 06:00
MHDA- 2015/06/10 06:00
CRDT- 2014/12/03 06:00
PHST- 2014/02/14 00:00 [received]
PHST- 2014/09/08 00:00 [revised]
PHST- 2014/09/09 00:00 [accepted]
PHST- 2014/12/03 06:00 [entrez]
PHST- 2014/12/03 06:00 [pubmed]
PHST- 2015/06/10 06:00 [medline]
AID - S0749-8063(14)00795-6 [pii]
AID - 10.1016/j.arthro.2014.09.007 [doi]
PST - ppublish
SO  - Arthroscopy. 2015 Feb;31(2):306-20. doi: 10.1016/j.arthro.2014.09.007. Epub 2014 
      Nov 14.