Platelet rich plasma as a treatment method for rotator cuff tears

The prevalence of the rotator cuff (RC) tears is ~ 21% in the general population, with higher incidences in individuals over 50. Irrespective of surgical repair techniques employed, re-tear rates are alarmingly high, indicating the need for improvement to the current treatment methods. A method that has recently increased in popularity is the administration of platelet-rich-plasma (PRP), as it has been proposed to significantly encourage and improve healing in a plethora of musculoskeletal tissues, although experimental conditions and results are often variable. This review aims to critically evaluate current literature concerning the use of PRP, specifically for the treatment of RC tears. There are ongoing conflicts debating the effectiveness of PRP to treat RC tears; with literature both in favour and against its use either having profound methodological weaknesses and/or limited applicability to most individuals with RC tears. There are numerous factors that may influence effectiveness, including the subgroup of patients studied and the timing and method of PRP delivery. Thus, in order to ascertain the clinical effectiveness of PRP for RC tears, the preparation protocol and composition of PRP must be standardised, so an accurate assessment and comparisons can be undertaken. Prior to clinical realisation, there is a requirement for a defined, standardised, quality-controlled protocol/procedure considering composition/formulation (of PRP); injury severity, dosage, frequency, timings, controls used, patient group, and rehabilitation programmes. Nevertheless, it is concluded that the initial step to aid the progression of PRP to treat RC tears is to standardise its preparation and delivery.