LP-PRP in Medium-Large Rotator Cuff Repair: RCT
Pandey V · J Shoulder Elbow Surg (2016)
DOI: 10.1016/j.jse.2016.01.036This RCT applied moderately concentrated LP-PRP during arthroscopic repair of medium to large rotator cuff tears in 102 patients. At 24 months, the PRP group showed significantly better Constant-Murley and UCLA scores and lower retear rates. However, this study has been the subject of controversy in subsequent meta-analyses because the lack of participant blinding may have introduced performance bias, and excluding it from pooled analyses reduces heterogeneity substantially.
Clinical Relevance
While the positive results are encouraging, the non-blinding concern means clinicians should weigh this study carefully. The LP-PRP formulation used aligns with emerging preferences for leukocyte-poor products in surgical augmentation contexts.
Key Takeaways
- LP-PRP significantly improved Constant and UCLA scores at 24 months
- Lower retear rate in PRP group
- Used LP-PRP (moderately concentrated, ~3-4x baseline)
- Non-blinding of participants is a recognized limitation
- Exclusion from meta-analyses markedly reduces heterogeneity, suggesting it may be an outlier
- Demonstrates the importance of blinding in PRP surgical augmentation trials
Key Findings
LP-PRP improved Constant and UCLA at 24mo. Lower retear. Positive outlier; some meta-analyses excluded due to non-blinding.
Clinical Context
Study Design
RCT
Condition
Medium to Large Rotator Cuff Tear
Sample Size
102 patients
Follow-up
24 months
Control Group
Standard ARCR
Primary Outcome
Constant-Murley, UCLA, VAS, MRI retear
PRP Protocol & Intervention
Leukocyte Status
LP-PRP
Platelet Concentration
~3-4x
Injection Frequency
1 injection(s)
Guidance Method
Intraoperative