Evaluation of platelet-rich plasma and fibrin matrix to assist in healing and repair of rotator cuff injuries: a systematic review and meta-analysis

Clin Rehabil. 2017 Feb;31(2):158-172. doi: 10.1177/0269215516634815. Epub 2016 Jul 10.

Abstract

Objective: To perform a meta-analysis examining the effectiveness of platelet-rich plasma and platelet-rich fibrin matrix for improving healing of rotator cuff injuries. Data sources/design: A meta-analysis of eligible studies was performed after searching Medline, Cochrane, and EMBASE on 14 December 2015.

Setting: University hospital.

Participants: Patients with rotator cuff injuries. Review methods/intervention: Databases were searched using the keywords "PRP or platelet-rich plasma," "PRFM or platelet-rich fibrin matrix," "rotator cuff," and "platelet-rich" for studies comparing outcomes of patients with rotator cuff injuries that did and did not receive a platelet-rich product.

Main measures: The primary outcome was a functional score change from pre- to post-treatment (Scorepost-Scorepre). The secondary outcome was a visual analogue scale (VAS) pain score change from pre- to post-treatment (VASpost-VASpre).

Results: A total of 11 studies were included in the meta-analysis. The total number of patients that received platelet-rich plasma or platelet-rich fibrin matrix was 320 and the number of control patients was 318. The standard difference in means of the functional scores was similar between patients administered platelet-rich plasma/fibrin matrix and patients in the control group (standard difference in means for functional scores = 0.029; 95% confidence interval (CI): -0.132 to 0.190; p = 0.725). The standard difference in means was similar between patients administered platelet-rich plasma and the controls (standard difference in means = 0.142; 95% CI: -0.080 to 0.364; p = 0.209).

Conclusion: The results of this meta-analysis do not support the use of platelet-rich plasma/platelet-rich fibrin matrix in patients with rotator cuff injuries.

Keywords: Platelet; fibrin; healing; plasma; repair; rotator cuff.

Publication types

  • Evaluation Study
  • Review
  • Systematic Review

MeSH terms

  • Arthroscopy / methods
  • Combined Modality Therapy
  • Female
  • Fibrin / therapeutic use*
  • Humans
  • Injury Severity Score
  • Male
  • Platelet-Rich Plasma*
  • Randomized Controlled Trials as Topic
  • Recovery of Function
  • Risk Assessment
  • Rotator Cuff Injuries / diagnosis
  • Rotator Cuff Injuries / therapy*
  • Treatment Outcome

Substances

  • Fibrin