Abstract：
BACKGROUND: Platelet-rich plasma (PRP) has been used for arthroscopic rotator cuff repairs (aRCR), but no studies have addressed the impact of platelet concentration. The primary aim was to evaluate whether the PRP cell concentration has an effect on tendon healing after aRCR compared with surgery alone. The secondary aim was to assess the functional and pain outcomes.
METHODS: A systematic review was performed with searches in the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane (Central) databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Metanalytic procedures were performed for randomized controlled trials (RCTs), and a subgroup analysis was used for studies with target (approximately 10 6 cells·μL -1 ) or below-target PRP cellular concentrations (app. 5 × 10 5 cells·μL -1 ) regarding the primary outcome of tendon healing.
RESULTS: This review included 10 studies (8 RCTs) with 342 patients in the aRCR + PRP group and 344 patients with isolated aRCR. The risk of bias was low to intermediate (6/4, respectively). Meta-analysis of the RCT revealed that the aRCR + high-concentration PRP group had an approximately 3.9-fold higher chance of healing than the non-PRP group (odds ratio, 3.89; 95% confidence interval, 1.78-8.44; P = 0.0007). No significant difference in healing was found between the aRCR + low-concentration PRP and non-PRP groups (odds ratio, 2.21; 95% confidence interval, 0.66-7.45; P = 0.2). The Constant-Murley score and University of California Los Angeles scores were significantly improved in the aRCR + PRP groups with more than 12 months of follow-up, and no significant differences were found consistently for the American Shoulder and Elbow Society and visual analog scale scores.
CONCLUSIONS: This study highlights that a PRP cell concentration close to the target (10 6 cells·μL -1 ) of patients with aRCR may improve their healing and functional outcomes and that dosing may be potentially useful in therapy.
METHODS: A systematic review was performed with searches in the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane (Central) databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Metanalytic procedures were performed for randomized controlled trials (RCTs), and a subgroup analysis was used for studies with target (approximately 10 6 cells·μL -1 ) or below-target PRP cellular concentrations (app. 5 × 10 5 cells·μL -1 ) regarding the primary outcome of tendon healing.
RESULTS: This review included 10 studies (8 RCTs) with 342 patients in the aRCR + PRP group and 344 patients with isolated aRCR. The risk of bias was low to intermediate (6/4, respectively). Meta-analysis of the RCT revealed that the aRCR + high-concentration PRP group had an approximately 3.9-fold higher chance of healing than the non-PRP group (odds ratio, 3.89; 95% confidence interval, 1.78-8.44; P = 0.0007). No significant difference in healing was found between the aRCR + low-concentration PRP and non-PRP groups (odds ratio, 2.21; 95% confidence interval, 0.66-7.45; P = 0.2). The Constant-Murley score and University of California Los Angeles scores were significantly improved in the aRCR + PRP groups with more than 12 months of follow-up, and no significant differences were found consistently for the American Shoulder and Elbow Society and visual analog scale scores.
CONCLUSIONS: This study highlights that a PRP cell concentration close to the target (10 6 cells·μL -1 ) of patients with aRCR may improve their healing and functional outcomes and that dosing may be potentially useful in therapy.
摘要：
背景：富血小板血浆（PRP）已用于关节镜肩袖修复（aRCR），但尚无研究探讨血小板浓度的影响.主要目的是评估与单独手术相比，ARCR后PRP细胞浓度是否对肌腱愈合有影响。次要目的是评估功能和疼痛结果。
方法：在MEDLINE（PubMed）中进行了系统评价，Scopus,WebofScience,和Cochrane（中央）数据库根据系统评价和荟萃分析指南的首选报告项目。对随机对照试验(RCT)进行元分析程序，亚组分析用于目标（约106个细胞·μL-1）或低于目标的PRP细胞浓度的研究（app。5×105细胞·μL-1）关于肌腱愈合的主要结果。
结果：本综述纳入了10项研究（8项RCT），其中aRCR+PRP组342例患者和孤立aRCR组344例患者。偏倚风险低至中等（分别为6/4）。RCT的Meta分析显示，aRCR+高浓度PRP组比非PRP组有约3.9倍的愈合机会（优势比，3.89；95%置信区间，1.78-8.44；P=0.0007）。aRCR+低浓度PRP组和非PRP组之间愈合无显著差异(比值比，2.21；95%置信区间，0.66-7.45；P=0.2）。在超过12个月的随访中，aRCR+PRP组的Constant-Murley评分和加州大学洛杉矶分校评分显著提高，在美国肩肘协会和视觉模拟量表评分中，没有发现显着差异。
结论：本研究强调，PRP细胞浓度接近aRCR患者的目标（106个细胞·μL-1）可能会改善其愈合和功能结果，并且剂量可能对治疗有用。
方法：在MEDLINE（PubMed）中进行了系统评价，Scopus,WebofScience,和Cochrane（中央）数据库根据系统评价和荟萃分析指南的首选报告项目。对随机对照试验(RCT)进行元分析程序，亚组分析用于目标（约106个细胞·μL-1）或低于目标的PRP细胞浓度的研究（app。5×105细胞·μL-1）关于肌腱愈合的主要结果。
结果：本综述纳入了10项研究（8项RCT），其中aRCR+PRP组342例患者和孤立aRCR组344例患者。偏倚风险低至中等（分别为6/4）。RCT的Meta分析显示，aRCR+高浓度PRP组比非PRP组有约3.9倍的愈合机会（优势比，3.89；95%置信区间，1.78-8.44；P=0.0007）。aRCR+低浓度PRP组和非PRP组之间愈合无显著差异(比值比，2.21；95%置信区间，0.66-7.45；P=0.2）。在超过12个月的随访中，aRCR+PRP组的Constant-Murley评分和加州大学洛杉矶分校评分显著提高，在美国肩肘协会和视觉模拟量表评分中，没有发现显着差异。
结论：本研究强调，PRP细胞浓度接近aRCR患者的目标（106个细胞·μL-1）可能会改善其愈合和功能结果，并且剂量可能对治疗有用。
