Full-thickness rotator cuff tear repair by injection of leukocyte-poor platelet-rich plasma: a comparison of low and high concentration groups

doi:10.12307/2023.140

Abstract

Abstract: BACKGROUND: In recent years, more and more scholars have focused on arthroscopic rotator cuff repair combined with platelet-rich plasma for the treatment of rotator cuff tears, in order to reduce the re-tear rate and improve the prognosis of patients. However, due to differences in the dosage form, activation state, frequency of use, timing of use, and concentration of platelet-rich plasma, the results of various clinical studies vary.
OBJECTIVE: To evaluate the effects of different concentrations of leucocyte platelet-rich plasma on postoperative pain, functional and structural integrity outcomes in patients accepted arthroscopic rotator cuff repair.
METHODS: A total of 80 patients with full-thickness tear of the rotator cuff admitted to the Affiliated Hospital of North China University of Science and Technology and The Second Hospital of Tangshan from January to September 2020 were included. The patients were randomly divided into two groups. In the control group (n=40), cases underwent arthroscopic rotator cuff repair. In the trial group (n=40), about 3 mL of autologous leukocyte-poor platelet-rich plasma was injected under the tendon in patients undergoing arthroscopic rotator cuff repair. Among them, the platelet concentration in the low-concentration group (n=20) injected into the leukocyte-poor platelet-rich plasma was (330.20±172.65)×109 L-1, and the platelet concentration in the high-concentration group (n=20) injected into the leukocyte-poor platelet-rich plasma was (807.76±218.98)×109 L-1. Visual analog scale scores, range of motion, shoulder function score, and re-tear rate of shoulder flexion lift and abduction lift of each group were were compared.
RESULTS AND CONCLUSION: (1) Visual analog scale scores of the trial group at 12 months after surgery was lower than that of the control group (P < 0.05). The visual analog score of the high-concentration group at 14 days and 1, 3, 6, and 12 months after surgery was lower than that of the low-concentration group (P < 0.05), but it did not reach the minimum clinical significance change value. (2) There was no significant difference in the range of motion of shoulder flexion lift and abduction lift among the groups at 12 months after operation (P > 0.05). (3) The American shoulder and elbow surgeons score 12 months after the operation in the high-concentration group was higher than that in the low-concentration group (P < 0.05), but did not reach the minimum clinical significant change value. There was no significant difference in shoulder joint function American shoulder and elbow surgeons score, Constant-Murley score and University of California, Los Angeles (P > 0.05). (4) At 12 months after operation, there was no significant difference in the rotator cuff re-tear rate between the groups (P > 0.05). (5) Low and high concentrations of leukocyte-poor platelet-rich plasma cannot improve postoperative range of motion, pain, function, and re-tear rates of patients with full-thickness rotator cuff tears. Therefore, this study does not recommend arthroscopic rotator cuff repair combined with leukocyte-poor platelet-rich plasma for the treatment of rotator cuff injury. But more research will be needed to confirm this conclusion.

Key words: rotator cuff tears, full-thickness rotator cuff tears, platelet-rich plasma concentration, platelet-rich plasma, rotator cuff, arthroscopy

CLC Number:

Bai Xiaosong, Gao Liying, Zhang Dingding, Liu Wenlong, Zhang Tao, Shen Xiaoyang, Liang Chunyu, Sun Xiaoxin. Full-thickness rotator cuff tear repair by injection of leukocyte-poor platelet-rich plasma: a comparison of low and high concentration groups[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(16): 2467-2472.

Figures/Tables 6

References

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