From Reuters Health Information

Platelet-Rich Fibrin Matrix Doesn't Boost Healing of Rotator Cuff Repair

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By Will Boggs MD

NEW YORK (Reuters Health) Dec 29 - An autologous platelet-rich fibrin matrix (PRFM) does not enhance healing after arthroscopic rotator cuff repair, European researchers reported online December 15th in The American Journal of Sports Medicine.

"The pressure to use the latest available products is great, and often we embrace new technologies in a relatively acritical fashion, simply because 'if it is new, it must be better,'" Dr. Nicola Maffulli from Barts and The London School of Medicine and Dentistry told Reuters Health. "We have shown that, in the context of surgical repair of fairly chronic small and moderate tears of the rotator cuff in mature patients, this particular form of platelet rich augmentation does not offer any advantages."

"Our healing abilities have evolved over millions of years, and we have been selected for our capacity and ability to heal," Dr. Maffulli added. "To think that a few shots of a not yet well characterized product injected at a fairly random time point of the healing process will work a miracle is probably expecting too much."

In a randomized trial conducted at Ospedale Civile, Jesi, Italy, Dr. Maffulli and colleagues assessed the efficacy and safety of autologous PRFM augmentation during arthroscopic rotator cuff repair in 88 patients.

At 16 months after surgery, on the 100-point Constant-Murley shoulder rating scale, patients had improved from an average score of 42.7 before surgery to 88.6 without PRFM and from a mean of 42.1 to a mean of 88.58 with PRFM.

Among 78 patients (38 without PRFM and 40 with PRFM) with MRI results, there were no significant differences in tendon thickness or size of the tendon footprint. There was a significant difference between the groups in tendon signal intensity, but the researchers say "it is difficult to give a clinical significance to this finding."

"It may well be that other formulations of platelet rich augmentation may work, or that platelet rich augmentation is effective in large and massive tears," Dr. Maffulli added. "The point that we make is that science has to progress through carefully planned studies. Injecting platelet rich augmentation products in 10,000 patients and then saying 'it works!' is not advancing science, though it may advance one's career and make their business prosper."

SOURCE: http://link.reuters.com/cuf24r

Am J Sports Med 2010.