Differences in the effectiveness of leukocyte-rich platelet-rich plasma compared with leukocyte-poor platelet-rich plasma in the treatment of rotator cuff surgery: an umbrella review of meta-analyses.
Meta-analyses
Platelet-rich plasma
Rotator cuff
Umbrella review
Journal
Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology
ISSN: 1590-9999
Titre abrégé: J Orthop Traumatol
Pays: Italy
ID NLM: 101090931
Informations de publication
Date de publication:
24 Oct 2024
24 Oct 2024
Historique:
received:
30
06
2024
accepted:
06
10
2024
medline:
24
10
2024
pubmed:
24
10
2024
entrez:
24
10
2024
Statut:
epublish
Résumé
An umbrella review of meta-analyses was conducted to evaluate the use of platelet-rich plasma (PRP) in arthroscopic surgeries of rotator cuff injury. The effectiveness of leukocyte-poor PRP and leukocyte-rich PRP in the treatment of rotator cuff surgery was also compared. Web of Science, Embase, PubMed/MEDLINE, and the Cochrane Library were searched from inception to May 2024. Literature screening, quality evaluation, and data extraction were performed according to the inclusion and exclusion criteria. The Jadad decision algorithm was used to ascertain which meta-analysis represented the best evidence. A total of 11 meta-analyses with evidence level ranging from level 1 to 2 were included in this umbrella review. Leukocyte-poor PRP was effective in reducing rotator cuff retear rates, alleviating pain, and increasing Constant scores compared with non-PRP treatments. However, it did not show improvement on the University of California Los Angeles (UCLA) score, the American Shoulder and Elbow Surgeons (ASES) score, and the Simple Shoulder Test (SST) compared with the non-PRP treatment group. Meanwhile, the leukocyte-rich PRP group improved the SST but showed no different results when compared with the non-PRP treatment group. Compared with no use of PRP, leukocyte-poor PRP was able to alleviate postoperative pain, reduce the retear rate, and improve the postoperative Constant score. Leukocyte-rich PRP could effectively enhance postoperative SST outcomes, leading to improvement of patient satisfaction and quality of life. Future researches should prioritize long-term follow-up studies and evaluate the durability of these results.
Sections du résumé
BACKGROUND
BACKGROUND
An umbrella review of meta-analyses was conducted to evaluate the use of platelet-rich plasma (PRP) in arthroscopic surgeries of rotator cuff injury. The effectiveness of leukocyte-poor PRP and leukocyte-rich PRP in the treatment of rotator cuff surgery was also compared.
METHODS
METHODS
Web of Science, Embase, PubMed/MEDLINE, and the Cochrane Library were searched from inception to May 2024. Literature screening, quality evaluation, and data extraction were performed according to the inclusion and exclusion criteria. The Jadad decision algorithm was used to ascertain which meta-analysis represented the best evidence.
RESULTS
RESULTS
A total of 11 meta-analyses with evidence level ranging from level 1 to 2 were included in this umbrella review. Leukocyte-poor PRP was effective in reducing rotator cuff retear rates, alleviating pain, and increasing Constant scores compared with non-PRP treatments. However, it did not show improvement on the University of California Los Angeles (UCLA) score, the American Shoulder and Elbow Surgeons (ASES) score, and the Simple Shoulder Test (SST) compared with the non-PRP treatment group. Meanwhile, the leukocyte-rich PRP group improved the SST but showed no different results when compared with the non-PRP treatment group.
CONCLUSION
CONCLUSIONS
Compared with no use of PRP, leukocyte-poor PRP was able to alleviate postoperative pain, reduce the retear rate, and improve the postoperative Constant score. Leukocyte-rich PRP could effectively enhance postoperative SST outcomes, leading to improvement of patient satisfaction and quality of life. Future researches should prioritize long-term follow-up studies and evaluate the durability of these results.
Identifiants
pubmed: 39446263
doi: 10.1186/s10195-024-00791-1
pii: 10.1186/s10195-024-00791-1
doi:
Types de publication
Journal Article
Comparative Study
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
50Subventions
Organisme : National Key R&D Program of China
ID : 2019YFA0111900
Organisme : National Natural Science Foundation of China
ID : 882072506
Organisme : National Natural Science Foundation of China
ID : 92268115
Organisme : National Natural Science Foundation of China
ID : 82272611
Organisme : National Clinical Research Center for Geriatric Disorders
ID : 2021KFJJ02
Organisme : National Clinical Research Center for Geriatric Disorders
ID : 2021LNJJ05
Organisme : National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation
ID : 2021-NCRC-CXJJ-PY-40
Organisme : Science and Technology Innovation Program of Hunan Province
ID : 2021JJ31105
Organisme : Hunan Provincial Innovation Foundation for Postgraduate
ID : CX20230312
Organisme : Hunan Provincial Innovation Foundation for Postgraduate
ID : CX20230308
Informations de copyright
© 2024. The Author(s).
Références
Adra M, El Ghazal N, Nakanishi H et al (2023) Platelet-rich plasma versus corticosteroid injections in the management of patients with rotator cuff disease: a systematic review and meta-analysis. J Orthop Res 41(1):7–20. https://doi.org/10.1002/jor.25463 . (publishedOnlineFirst:20221031)
doi: 10.1002/jor.25463
pubmed: 36250611
Teunis T, Lubberts B, Reilly BT, Ring D (2014) A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg 23(12):1913–1921. https://doi.org/10.1016/j.jse.2014.08.001
doi: 10.1016/j.jse.2014.08.001
pubmed: 25441568
Li Y, Li T, Li J, Tang X, Li R, Xiong Y (2022) Platelet-rich plasma has better results for retear rate, pain, and outcome than platelet-rich fibrin after rotator cuff repair: a systematic review and meta-analysis of randomized controlled trials. Arthroscopy 38(2):539–550. https://doi.org/10.1016/j.arthro.2021.05.023 . (publishedOnlineFirst:20210527)
doi: 10.1016/j.arthro.2021.05.023
pubmed: 34052384
Jancuska J, Matthews J, Miller T, Kluczynski MA, Bisson LJ (2018) A systematic summary of systematic reviews on the topic of the rotator cuff. Orthop J Sports Med 6(9):2325967118797891. https://doi.org/10.1177/2325967118797891
doi: 10.1177/2325967118797891
pubmed: 30320144
Jeong HJ, Nam KP, Yeo JH, Rhee S-M, Oh JH (2022) Retear after arthroscopic rotator cuff repair results in functional outcome deterioration over time. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N. Am Int Arthrosc Assoc 38(8):2399–2412. https://doi.org/10.1016/j.arthro.2022.02.016
doi: 10.1016/j.arthro.2022.02.016
de Vos RJ, Weir A, van Schie HTM et al (2010) Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 303(2):144–149. https://doi.org/10.1001/jama.2009.1986
doi: 10.1001/jama.2009.1986
pubmed: 20068208
Wang Z, Zhu P, Liao B, You H, Cai Y (2023) Effects and action mechanisms of individual cytokines contained in PRP on osteoarthritis. J Orthop Surg Res 18(1):713. https://doi.org/10.1186/s13018-023-04119-3
doi: 10.1186/s13018-023-04119-3
pubmed: 37735688
pmcid: 10515001
Nourissat G, Mainard D, Kelberine F (2013) Current concept for the use of PRP in arthroscopic surgery. Orthop Traumatol Surg Res OTSR 99(8 Suppl):S407–S410. https://doi.org/10.1016/j.otsr.2013.10.010
doi: 10.1016/j.otsr.2013.10.010
pubmed: 24239107
Di Martino A, Boffa A, Andriolo L et al (2022) Leukocyte-rich versus leukocyte-poor platelet-rich plasma for the treatment of knee osteoarthritis: a double-blind randomized trial. Am J Sports Med 50(3):609–617. https://doi.org/10.1177/03635465211064303
doi: 10.1177/03635465211064303
pubmed: 35103547
Riboh JC, Saltzman BM, Yanke AB, Fortier L, Cole BJ (2016) Effect of leukocyte concentration on the efficacy of platelet-rich plasma in the treatment of knee osteoarthritis. Am J Sports Med 44(3):792–800. https://doi.org/10.1177/0363546515580787
doi: 10.1177/0363546515580787
pubmed: 25925602
Ioannidis JPA (2009) Integration of evidence from multiple meta-analyses: a primer on umbrella reviews, treatment networks and multiple treatments meta-analyses. CMAJ Can Med Assoc J J de L’Assoc Med Can 181(8):488–493. https://doi.org/10.1503/cmaj.081086
doi: 10.1503/cmaj.081086
Blom AW, Donovan RL, Beswick AD, Whitehouse MR, Kunutsor SK (2021) Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence. BMJ 374:n1511. https://doi.org/10.1136/bmj.n1511
doi: 10.1136/bmj.n1511
pubmed: 34233885
pmcid: 8262448
Fusar-Poli P, Radua J (2018) Ten simple rules for conducting umbrella reviews. Evid Based Ment Health. https://doi.org/10.1136/ebmental-2018-300014
doi: 10.1136/ebmental-2018-300014
pubmed: 30006442
pmcid: 10270421
Smith V, Devane D, Begley CM, Clarke M (2011) Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol 11(1):15. https://doi.org/10.1186/1471-2288-11-15
doi: 10.1186/1471-2288-11-15
pubmed: 21291558
pmcid: 3039637
Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NCA, Faloppa F (2013) Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD009020.pub2
doi: 10.1002/14651858.CD009020.pub2
pubmed: 24475489
pmcid: 10846357
Shea BJ, Reeves BC, Wells G et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ (Clinical Research ed) 358:j4008. https://doi.org/10.1136/bmj.j4008
doi: 10.1136/bmj.j4008
pubmed: 28935701
Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ (Clinical Research ed) 339:b2700. https://doi.org/10.1136/bmj.b2700
doi: 10.1136/bmj.b2700
pubmed: 19622552
Chen J, Chen S, Luo H, Wu W, Wang S (2023) The application of arsenic trioxide in cancer: an umbrella review of meta-analyses based on randomized controlled trials. J Ethnopharmacol 316:116734. https://doi.org/10.1016/j.jep.2023.116734
doi: 10.1016/j.jep.2023.116734
pubmed: 37290735
Belk JW, Lim JJ, Keeter C et al (2023) Patients with knee osteoarthritis who receive platelet-rich plasma or bone marrow aspirate concentrate injections have better outcomes than patients who receive hyaluronic acid: systematic review and meta-analysis. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 39(7):1714–1734. https://doi.org/10.1016/j.arthro.2023.03.001
doi: 10.1016/j.arthro.2023.03.001
Peng Y, Guanglan W, Jia S, Zheng C (2022) Leukocyte-rich and Leukocyte-poor platelet-rich plasma in rotator cuff repair: a meta-analysis. Int J Sports Med 43(11):921–930. https://doi.org/10.1055/a-1790-7982
doi: 10.1055/a-1790-7982
pubmed: 35255508
Sanchez MJ, Mossayebi A, Sigaroodi S et al (2023) Effects of neuromuscular electrical stimulation on glycemic control: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 14:1222532. https://doi.org/10.3389/fendo.2023.1222532
doi: 10.3389/fendo.2023.1222532
pubmed: 37583429
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ (Clinical Research ed) 339:b2535. https://doi.org/10.1136/bmj.b2535
doi: 10.1136/bmj.b2535
pubmed: 19622551
Chen J, Chen S, Luo H et al (2023) The negative effect of concomitant medications on immunotherapy in non-small cell lung cancer: an umbrella review. Int Immunopharmacol 124(Pt B):110919. https://doi.org/10.1016/j.intimp.2023.110919
doi: 10.1016/j.intimp.2023.110919
pubmed: 37722262
Saltzman BM, Zuke WA, Go B et al (2017) Does early motion lead to a higher failure rate or better outcomes after arthroscopic rotator cuff repair? A systematic review of overlapping meta-analyses. J Shoulder Elbow Surg 26(9):1681–1691. https://doi.org/10.1016/j.jse.2017.04.004
doi: 10.1016/j.jse.2017.04.004
pubmed: 28619382
Jadad AR, Cook DJ, Browman GP (1997) A guide to interpreting discordant systematic reviews. CMAJ 156(10):1411–1416
pubmed: 9164400
pmcid: 1227410
Guo Y, Yin F, Fan C, Wang Z (2018) Gender difference in clinical outcomes of the patients with coronary artery disease after percutaneous coronary intervention: a systematic review and meta-analysis. Medicine 97(30):e11644
doi: 10.1097/MD.0000000000011644
pubmed: 30045311
pmcid: 6078653
Zhao D, Han Y-H, Pan J-K et al (2021) The clinical efficacy of leukocyte-poor plateletrich plasma in arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials. J Shoulder Elbow Surg 30(4):918–928. https://doi.org/10.1016/j.jse.2020.10.014
doi: 10.1016/j.jse.2020.10.014
pubmed: 33220417
Lin C, Ren Y, Lu A (2023) The effectiveness of virtual reality games in improving cognition, mobility, and emotion in elderly post-stroke patients: a systematic review and meta-analysis. Neurosurg Rev 46(1):167. https://doi.org/10.1007/s10143-023-02061-w
doi: 10.1007/s10143-023-02061-w
pubmed: 37415057
Feltri P, Gonalba GC, Boffa A et al (2023) Platelet-rich plasma does not improve clinical results in patients with rotator cuff disorders but reduces the retear rate. A systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 31(5):1940–1952. https://doi.org/10.1007/s00167-022-07223-9 . (published Online First: 20221211)
doi: 10.1007/s00167-022-07223-9
pubmed: 36496450
Xu W, Xue Q (2021) Application of platelet-rich plasma in arthroscopic rotator cuff repair: a systematic review and meta-analysis. Orthop J Sports Med. https://doi.org/10.1177/23259671211016847
doi: 10.1177/23259671211016847
pubmed: 34901289
pmcid: 8655457
Chen X, Jones IA, Togashi R, Park C, Vangsness CT Jr (2020) Use of platelet-rich plasma for the improvement of pain and function in rotator cuff tears: a systematic review and meta-analysis with bias assessment. Am J Sports Med 48(8):2028–2041. https://doi.org/10.1177/0363546519881423 . (publishedOnlineFirst:20191119)
doi: 10.1177/0363546519881423
pubmed: 31743037
Wang C, Xu M, Guo W, Wang Y, Zhao S, Zhong L (2019) Clinical efficacy and safety of platelet-rich plasma in arthroscopic full-thickness rotator cuff repair: a meta-analysis. PLoS ONE 14(7):e0220392. https://doi.org/10.1371/journal.pone.0220392 . (publishedOnlineFirst:20190729)
doi: 10.1371/journal.pone.0220392
pubmed: 31356630
pmcid: 6663026
Han C, Na Y, Zhu Y et al (2019) Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 14(1):183. https://doi.org/10.1186/s13018-019-1207-9 . (publishedOnlineFirst:20190620)
doi: 10.1186/s13018-019-1207-9
pubmed: 31221198
pmcid: 6585122
Zhao JG, Zhao L, Jiang YX, Wang ZL, Wang J, Zhang P (2015) Platelet-rich plasma in arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials. Arthroscopy 31(1):125–135. https://doi.org/10.1016/j.arthro.2014.08.008 . (publishedOnlineFirst:20140930)
doi: 10.1016/j.arthro.2014.08.008
pubmed: 25278352
Yang FA, Liao CD, Wu CW, Shih YC, Wu LC, Chen HC (2020) Effects of applying platelet-rich plasma during arthroscopic rotator cuff repair: a systematic review and meta-analysis of randomised controlled trials. Sci Rep 10(1):17171. https://doi.org/10.1038/s41598-020-74341-0 . (publishedOnlineFirst:20201014)
doi: 10.1038/s41598-020-74341-0
pubmed: 33057143
pmcid: 7560855
Ryan J, Imbergamo C, Sudah S et al (2021) Platelet-rich product supplementation in rotator cuff repair reduces retear rates and improves clinical outcomes: a meta-analysis of randomized controlled trials. Arthroscopy 37(8):2608–2624. https://doi.org/10.1016/j.arthro.2021.03.010 . (publishedOnlineFirst:20210317)
doi: 10.1016/j.arthro.2021.03.010
pubmed: 33744318
pmcid: 8349828
Zhang Q, Ge HA, Zhou J, Cheng B (2013) Are platelet-rich products necessary during the arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis. PLoS ONE. https://doi.org/10.1371/journal.pone.0069731
doi: 10.1371/journal.pone.0069731
pubmed: 24416095
pmcid: 3877383
Cai YZ, Zhang C, Lin XJ (2015) Efficacy of platelet-rich plasma in arthroscopic repair of full-thickness rotator cuff tears: a meta-analysis. J Shoulder Elbow Surg 24(12):1852–1859. https://doi.org/10.1016/j.jse.2015.07.035 . (publishedOnlineFirst:20151009)
doi: 10.1016/j.jse.2015.07.035
pubmed: 26456434
Lv M, Xu Q, He F et al (2023) Transosseous-equivalent/suture bridge technique in combination with platelet-rich plasma application yield optimal clinical outcomes in arthroscopic rotator cuff repair: a bayesian network analysis of randomized controlled trials. Arthroscopy 39(2):425–37.e1. https://doi.org/10.1016/j.arthro.2022.10.039 . (publishedOnlineFirst:20221105)
doi: 10.1016/j.arthro.2022.10.039
pubmed: 36343767
Jiang X, Zhang H, Wu Q, Chen Y, Jiang T (2023) Comparison of three common shoulder injections for rotator cuff tears: a systematic review and network meta-analysis. J Orthop Surg Res 18(1):272. https://doi.org/10.1186/s13018-023-03747-z
doi: 10.1186/s13018-023-03747-z
pubmed: 37013620
pmcid: 10069022
Hurley E, Maye A, Mullett H (2019) Arthroscopic rotator cuff repair: a systematic review of overlapping meta-analyses. JBJS Reviews 7:1. https://doi.org/10.2106/JBJS.RVW.18.00027
doi: 10.2106/JBJS.RVW.18.00027
Saltzman BM, Jain A, Campbell KA et al (2016) Does the use of platelet-rich plasma at the time of surgery improve clinical outcomes in arthroscopic rotator cuff repair when compared with control cohorts? A systematic review of meta-analyses. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Ame Int Arthrosc Assoc 32(5):906–918. https://doi.org/10.1016/j.arthro.2015.10.007
doi: 10.1016/j.arthro.2015.10.007
Cavendish PA, Everhart JS, DiBartola AC, Eikenberry AD, Cvetanovich GL, Flanigan DC (2020) The effect of perioperative platelet-rich plasma injections on postoperative failure rates following rotator cuff repair: a systematic review with meta-analysis. J Shoulder Elbow Surg 29(5):1059–1070. https://doi.org/10.1016/j.jse.2020.01.084
doi: 10.1016/j.jse.2020.01.084
pubmed: 32305103