Improving healing after a rotator cuff tendon repair is an ongoing problem for orthopaedic surgeons world-wide. Researchers, presenting a study at the American Orthopaedic Society for Sports Medicine’s Specialty Day in San Diego found that one of the latest tools for healing injuries, platelet-rich plasma (PRP), does not make a big difference.
“Our study on 79 patients who received platelet-rich plasma with a fibrin matrix (PRFM) demonstrated no real differences in healing in a tendon-to-bone rotator cuff repair. In fact, this preliminary analysis suggests that the PRFM, as used in this study, may have a negative effect on healing. However, this data should be viewed as preliminary, and further study is required” said study author, Scott Rodeo, MD of New York City’s Hospital for Special Surgery.
The randomized trial broke the 79 patients into two groups: those that received the PRFM and those that did not. Standardized rotator cuff repair techniques were used for all patients along with post-operative rehabilitation protocols. The tendon healing was evaluated using ultrasound at six and 12 weeks post-operation. Ultrasound was also used to determine blood flow in various areas of the repaired tendon. The researchers also looked at shoulder movement outcome scales and strength measurements.
Researchers think there may be several reasons for a lack of response in healing, including variability in the way platelets are recovered, platelet activation and the mechanisms for the way the PRFM reacts with the tendon cells. The study was also unable to document the number of platelets actually delivered to patients who received the PRFM. Platelets are the cells that help control bleeding and healing.
“Additional research needs to be performed to figure out the mechanisms for why PRP is successful in healing certain areas of the body and not others. With more study we will continue to learn new procedures for improving orthopaedic surgery outcomes,” said Rodeo.
Source: Lisa Weisenberger
American Orthopaedic Society for Sports Medicine