ARCR + PRP Reduces Retearing (Level I RCTs Only)
Song Y · Medicine (2024)
DOI: 10.1097/MD.0000000000038069This 2024 meta-analysis focused exclusively on high-quality (Level I) RCTs evaluating PRP during arthroscopic rotator cuff repair. The most important finding was a subgroup analysis showing that PRP benefit was significant in single-row repairs but masked in double-row repairs. This makes biological sense: double-row repair already provides strong biomechanical fixation, so the additional healing benefit of PRP becomes redundant. PRP adds the most value when the repair construct is mechanically weaker.
Clinical Relevance
Refines the indication for PRP in rotator cuff repair. Surgeons performing single-row repairs should strongly consider PRP augmentation. For double-row repairs, the marginal benefit is less clear and may not justify the additional cost and preparation time.
Key Takeaways
- PRP reduced retear rates overall (confirming prior meta-analyses)
- Single-row repair: PRP benefit SIGNIFICANT (weaker construct benefits from biological augmentation)
- Double-row repair: PRP benefit MASKED (already strong fixation makes PRP redundant)
- VAS improved short-term but not long-term
- UCLA scores showed no medium/long-term improvement
- Only included Level I RCTs for maximum rigor
Key Findings
PRP reduced retear. Single-row repair benefited; double-row MASKED effect. PRP most useful for single-row repairs.
Clinical Context
Study Design
Meta-Analysis
Condition
Arthroscopic RCR
Control Group
Standard ARCR
Primary Outcome
Retear, UCLA, Constant, VAS
PRP Protocol & Intervention
Preparation System
Various
Injection Frequency
1 injection(s)
Guidance Method
Intraoperative