PRP/PRF in Rotator Cuff Repair: 18 RCT Meta-Analysis
Hurley ET · Am J Sports Med (2019)
DOI: 10.1177/0363546517751397This landmark meta-analysis pooled 18 RCTs with 1147 patients to evaluate PRP and PRF augmentation during arthroscopic rotator cuff repair. The key finding was a clear divergence between PRP (which significantly reduced retear rates across all tear sizes) and PRF (which showed no benefit). This established PRP as an effective surgical augmentation tool for rotator cuff repair and differentiated it from other platelet-derived products.
Clinical Relevance
Strong evidence to support PRP (but NOT PRF) augmentation during arthroscopic rotator cuff repair. The nearly 50% reduction in retear rate is clinically meaningful. Surgeons should use PRP rather than PRF when choosing platelet-based augmentation.
Key Takeaways
- PRP reduced retear rates: all tears 17.2% vs 30.5%, small-medium 22.4% vs 38.3%, medium-large 12.3% vs 30.5% (all p<0.05)
- PRF showed NO benefit for retear rates or functional outcomes
- PRP and PRF are not interchangeable despite both being platelet-derived
- 18 RCTs, 1147 patients (robust evidence base)
- PRP augmentation should be applied at the bone-tendon interface during repair
Key Findings
PRP retear: 17.2% vs 30.5% (all), 22.4% vs 38.3% (small-med), 12.3% vs 30.5% (med-large). PRF: NO benefit.
Clinical Context
Study Design
Meta-Analysis
Condition
Arthroscopic RCR Augmentation
Sample Size
1147 patients
Control Group
Standard RCR
Primary Outcome
Retear Rate, Constant, VAS
PRP Protocol & Intervention
Preparation System
Various (18 RCTs)
Leukocyte Status
Mixed
Activation Method
Various
Injection Frequency
1 injection(s)
Guidance Method
Intraoperative bone-tendon interface