Table 1:
Summary of included studies
| L-PRP | Level of Evidence | N | Follow up (Imaging/Clinical) |
Tear size | Outcomes | Significant difference | No significant difference |
|---|---|---|---|---|---|---|---|
| Randelli et al(2011) | 1 | 53 (26 PRP, 27 control) | 24 months | <6mm | SST, UCLA, Constant scores, strength in ER higher in the treatment group at 3 months postoperatively. No difference after 6, 12, and 24 months. MRI showed no significant difference in the healing rate of the rotator cuff tear. Pain score in the treatment group was lower than the control group at 3, 7, 14, and 30 days after surgery. | Pain up to 30 days, SST, UCLA, Constant, ER strength at 3 months | Retear rates, SST, UCLA, Constant ER strength beyond 3 months |
| Zhang et al(2016) | 1 | 60 (30 PRP, 30 control) | 12 months | >1cm | DASH, Constant, VAS, ROM (FF, IR, ER), MRI. No differences in any clinical outcomes between groups, but the retear rate was significantly lower in the PRP group compared to the controls. | Retear rates | DASH, Constant, VAS, ROM |
| L-PRF | N | Follow up | Tear size | Outcomes | Significant difference | No significant difference | |
| Zumstein (2016) | 1 | 35 (17 PRP, 18 control) | 12 months | N/A (mean size 2.14cm PRP, 1.61 control) | L-PRF yielded no beneficial effect in clinical outcome, anatomic healing rate, mean postoperative defect size, and tendon quality at 12 months follow-up. | Constant score and active flexion at 6mo postoperatively, (neither of these metrics at 12mo latest timepoint) | Subjective Shoulder Value, patient satisfaction, VAS, SST, Constant, MRI healing rate |
| Gumina et al(2012) | 1 | 76 (39 PRP, 37 control) | 12 months | 2–4 cm | No differences in pain or Constant scores. Repair integrity significantly improved compared to control group. | Repair integrity/Retear rates | Pain, Constant |
| P-PRP | N | Follow up | Tear size | Outcomes | Significant difference | No significant difference | |
| Auuna et al(2013) | 1 | 28 (14 PRP, 14 control) | 12 months / 24 months | >5cm | No significant difference between PRF and control groups for Constant, DASH, VAS scores. Retear rate similar between groups. | None | Retear rate, Constant, DASH, VAS |
| Ebert et al(2017) | 1 | 60 (30 PRP, 30 control) | 36 months | <2cm | No difference in PROM, Constant (although strength subscore differed significantly), or retear rate. | Strength subset of Constant score | Retear rate, Constant, PROM |
| Pandey et al (2016) | 1 | 102 (52 PRP, 50 control) | 24 months | 1–5 cm | VAS was better in the PRP group at all time points except for 24 months. For the PRP group, Constant scores were greater at 12 and 24 months, and UCLA scores were significantly higher at 6 and 12 months, but not 24 months. No difference in ASES. Retear in the PRP group was significantly lower than in the control group, significant only for large tears. | Retear rates specifically in large tears, VAS at all time points except 24 months, Constant score, UCLA at 6 and 12 months, vascularity | ASES Scores, 24 month VAS and UCLA scores |
| Jo et al(2015) | 1 | 74 (37 PRP, 37 control) | 9 months / 12 months | 1–5 cm | Constant, VAS, ROM, strength, satisfaction, functional scores, retear rate, and change in cross-sectional area. All results were not singificantly different between groups with the exception of retear rate and 12-month difference in cross-sectional area. | Retear Rates, cross sectional area of repair | Constant, VAS, ROM, Strength, Satisfaction |
| Jo et al(2013) | 1 | 48(24 PRP, 24 control) | 5 years | >3cm | Retear rate, cross-sectional area, pain, range of motion, muscle strength, overall satisfaction, ASES, Constant, UCLA, DASH, SST, and SPADI scores. The retear rate of the PRP group was significantly lower than the conventional group. Clinical outcomes showed no statistical difference except for the overall function. The change in postoperative CSA was significantly different between the two groups. | Retear rates, cross sectional area of repair, overall function | Pain, range of motion, muscle strength,
ASES, Constant, UCLA, DASH, SST, and SPADI scores |
| Malavolta (2018) | 2 | 51 (26 PRP, 25 control) | 12 months / 24 months | <3cm | Retear rate (reported as Sugaya type IV or V), UCLA, Constant, VAS. None of the clinical assessments in either grouP-PRoduced statistically significant differences. The overall number of retears did not differ between groups. | None | Retear rate (reported as Sugaya type IV or V), UCLA, Constant, VAS |
| P-PRF | N | Follow up | Tear size | Outcomes | Significant difference | No significant difference | |
| Catricini et al(2011) | 1 | 88 (43 PRP, 45 control) | 16 months | <3cm | There was no statistically significant difference in total Constant score between the two groups. There was no statistically significant difference in MRI tendon score when comparing arthroscopic repair with or without PRFM. | None | MRI, Constant |
| Flury et al (2016) | 1 | 120 (60 PRP, 60 control) | 24 months | N/A (mean size 2.35cm PRP, 2.0cm control) | No significant differences in Constant, OSS, ASES, qDASH, EuroQol 5 dimensions. No significant difference in pain between groups. No difference in retear rate between the PRP and control groups. | None | Constant score, OSS (Oxford Shoulder Score), ASES, DASH, EuroQol 5 dimensions, pain score, MRI or U/S |
| Rodeo et al(2012) | 2 | 79 (40 PRP, 39 control) | 12 months | <5cm | PRF had no demonstrable effect on tendon healing, tendon vascularity, manual muscle strength, or clinical rating scales. The regression analysis suggested that PRF may have a negative effect on healing. | Retear rate; When comparing PRF versus control for each repair type, there was a significantly higher failure rate in the PRF, double-row/transosseousequivalent repairs at 12 weeks | ASES, L’Insalata, U/S (no difference in overall intact repair rate between the two groups), vascularity, strength |
| Ruiz-Moneo et al(2013) | 1 | 63 (32 PRP, 31 control) | 12 months | All tear sizes (<1cm to >5cm) |
No differences in rotator cuff healing or improvements in function were observed in the 1-year postsurgical clinical and radiological follow-up assessments. | None | UCLA, MRI (arthro-MRI) |
| Walsh et al(2018) | 2 | 76 (38 PRP, 38 control) | 6 months / 24 months | N/A (mean size PRP: AP 2.3cm, ML 1.9. Control: AP 2.3, ML 2.1) |
Results showed no benefit from PRPFM used for rotator cuff repair according to the WORC Index, SST, shoulder strength index, MRI assessment. | None | WORC (Western Ontario RC), SST, shoulder strength index, MRI |
| Weber et al(2013) | 1 | 60 (30 PRP, 30 control) | 3 months / 12 months | N/A (mean size 1.77 PRP, 1.72cm control) | Platelet-rich fibrin matrix was not shown to significantly improve clinical outcomes or structural integrity. | UCLA | ROM, VAS, narcotic consumption, SST, ASES, MRI |
| Márquez (2011) | 2 | 28 (14 PRP, 14 control) | 12 months | >5cm | No significant differences in Constant scores between both groups. No differences were found in the number of re-tears between the study and control groups. | None | Constant, MRI |