Editorial Commentary: Platelet-Rich Plasma for Rotator Cuff Repairs: No Evidence for Improved Long-Term Outcomes … Yet!

Abstract

Platelet-rich plasma (PRP) is an autologous blood product containing a high concentration of platelets, growth factors, and cytokines, which basic science studies have shown may improve tendon healing by promoting angiogenesis, cellular migration, proliferation, and matrix deposition. However, there is still controversy over its clinical efficacy, with randomized controlled trials and subsequent meta-analyses finding mixed results when PRP is used to augment rotator cuff repair. Meta-analyses have found that leukocyte-poor PRP significantly reduces the rate of incomplete tendon healing and retear, but the evidence does not support the use of leukocyte-rich PRP or platelet-rich fibrin matrix compositions. Optimizing PRP use may be as simple as the right PRP preparation or the right concentration of the important cytokines.