Platelet-Rich Plasma Reduces Retear Rates After Arthroscopic Repair of Small- and Medium-Sized Rotator Cuff Tears but Is Not Cost-Effective

Abstract

In large tears, even with double-row repair, the beneficial effects of PRP alone are insufficient to compensate the progressed tissue damage. The study data suggest that PRP may promote healing of small- and medium-sized tears to reduce retear rates. However, despite the substantial biological effect, at current cost, the use of PRP is not cost-effective in arthroscopic repair of small- and medium-sized tears.

An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature

“…Upon subgroup analysis, it was found that tears ≤3 cm had a significantly reduced risk of re-tear by 40% when PRP was used [35]. This difference was not observed for larger tears >3 cm [35]. Although functional and pain outcomes were not assessed by this meta-analysis, several additional meta-analyses were conducted which found similar results to the Cochrane review [36, 37].…”

“…Adding to the results of the above review, a meta-analysis conducted by Vavken et al (2015) included an additional seven trials [35]. Overall, only a 13% decrease in the risk of re-tear rate was found when PRP was used [35].…”

“…Overall, only a 13% decrease in the risk of re-tear rate was found when PRP was used [35]. Upon subgroup analysis, it was found that tears ≤3 cm had a significantly reduced risk of re-tear by 40% when PRP was used [35]. This difference was not observed for larger tears >3 cm [35].…”

Editorial Commentary: PRP: Platelet-Rich Plasma or Promising but Rarely Proven?

“…Specifically, at a $750 PRP cost, retear rates would need to decrease by 9.1% to be cost-effective. Interestingly, in a recent meta-analysis and similar cost-effective study by Vavken et al, 10 PRP was also not found to be costeffective in both small and large tears. In an academic setting, a PRP cost of $834 (venipuncture, kit, including OR time) would require a reduction of 1 retear in 14 patients (7.1%) to be cost-effective.…”

Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis

“…Vavken et al performed a meta-analysis on rotator cuff repair augmented with platelet concentrates [23]. The study data suggested that PRP might promote healing of smalland medium-sized (\3 cm) tears.…”