SECEC Research Grant 2008 II: Use of platelet- and leucocyte-rich fibrin (L-PRF) does not affect late rotator cuff tendon healing: a prospective randomized controlled study

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• 作者：Matthias A. Zumstein ; MDp>ap> ; Adam Rumian ; MD ; FRCS (Tr&Orth)p>ap> ; Charles &Eacute ; douard Th&eacute ; lu ; MDp>ap> ; Virginie Lesbats ; MDp>bp> ; Kieran O'Shea ; FRCSIp>ap> ; Michael Schaer ; MDp>ap> ; Pascal Boileau ; MDp>ap>p> ; p>p>boileau.p@chu-nice.fr" class="auth_mail" title="E-mail the corresponding authorp>
• 关键词：Level I ; Randomized Controlled Trial ; Treatment Study
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：25
• 期：1
• 页码：2-11
• 全文大小：536 K

文摘

Because the retear rate after rotator cuff repairs remains high, methods to improve healing are very much needed. Platelet-rich concentrates have been shown to enhance tenocyte proliferation and promote extracellular matrix synthesis in vitro; however, their clinical benefit remains unclear. We hypothesized that arthroscopic rotator cuff repair with leucocyte- and platelet-rich fibrin (L-PRF) results in better clinical and radiographic outcome at 12 months of follow-up than without L-PRF.p>

Methods

<p id="abspara0015">Thirty-five patients were randomized to receive arthroscopic rotator cuff repair with L-PRF locally applied to the repair site (L-PRF+ group, n = 17) or without L-PRF (L-PRF− group, n = 18). Preoperative and postoperative clinical evaluation included the Subjective Shoulder Value, visual analog score for pain, Simple Shoulder Test, and Constant-Murley score. The anatomic watertight healing, tendon thickness, and tendon quality was evaluated using magnetic resonance arthrography at 12 months of follow-up.p>

Results

<p id="abspara0020">No complications were reported in either group. The mean Subjective Shoulder Value, Simple Shoulder Test, and Constant-Murley scores increased from preoperatively to postoperatively, showing no significant differences between the groups. Complete anatomic watertight healing was found in 11 of 17 in the L-PRF+ group and in 11 of 18 in the L-PRP− group (P = .73). The mean postoperative defect size (214 &plusmn; 130 mmp>2p> in the L-PRF+ group vs 161 &plusmn; 149 mmp>2p> in the L-PRF− group; P = .391) and the mean postoperative tendon quality according to Sugaya (L-PRF+ group: 3.0 &plusmn; 1.4, L-PRF− group: 3.0 &plusmn; 0.9) were similar in both groups at 12 months of follow-up.p>

Conclusion

<p id="abspara0025">Arthroscopic rotator cuff repair with application of L-PRF yields no beneficial effect in clinical outcome, anatomic healing rate, mean postoperative defect size, and tendon quality at 12 months of follow-up.