Platelet Concentration Does Not Influence Clinical Efficacy and Retear Rates of Rotator Cuff Repair With Platelet-Rich Plasma: A Systematic Review and Meta-analysis With Meta-Regression.

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Study Summary

10 RCTs, including 696 patients undergoing rotator cuff repair (RCR), were included in this systematic review and meta-analysis evaluating platelet-rich plasma (PRP) augmentation and comparing outcomes according to high-dose versus low-dose PRP. High-dose PRP was defined as a platelet concentration >4 times that of whole blood, while low-dose PRP was defined as <4 times baseline concentration. Pooled outcomes included visual analogue scale (VAS) pain scores, Constant-Murley (CM) scores, American Shoulder and Elbow Surgeons (ASES) scores, University of California–Los Angeles (UCLA) shoulder scores, and rotator cuff retear rates. Overall, PRP augmentation was associated with lower pain, improved CM scores, and lower retear rates compared with RCR alone; however, subgroup and meta-regression analyses found no significant relationship between platelet dose and any clinical outcome or retear rate. These findings suggested that increasing platelet concentration beyond 4 times baseline did not provide additional clinical or structural benefit following RCR.