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Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le dimanche 10 mars 2019
Doi : 10.1016/j.otsr.2019.01.003
Received : 3 April 2018 ;  accepted : 8 January 2019
Autologous Conditioned Plasma for tendon healing following arthroscopic rotator cuff repair. Prospective comparative assessment with magnetic resonance arthrography at 6 months’ follow-up
 

Jean-Charles Aurégan a, b, Shahnaz Klouche a, , Bruno Levy a, Thomas Bauer a, Benoit Rousselin a, Mathieu Ferrand a, Philippe Hardy a, c
a Hôpitaux universitaires Paris Île-de-France Ouest, AP–HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France 
b Laboratoire de bioingénierie et bioimagerie ostéo-articulaire B2OA UMR7052, 10, avenue de Verdun, 75010 Paris, France 
c UFR des sciences de la santé, université de Versailles Saint-Quentin, 78035 Versailles, France 

Corresponding author.
Abstract
Introduction

Despite improvements in technique and materials for rotator cuff repair, mean re-tear rates remain close to 30%. The aim of the present study was to assess injection of Autologous Conditioned Plasma (ACP™, Arthrex) for tendon healing after arthroscopic repair. The study hypothesis was that ACP™ improves the tendon-healing rate.

Material and method

A non-randomized comparative prospective study included all patients aged over 18 years operated on in 2010 for arthroscopic repair of full-thickness rotator cuff tear with2 fatty degeneration on the Goutallier classification, whatever the severity of retraction, on virgin non-osteoarthritic shoulder without contraindications for magnetic resonance (MR) arthrography. The surgical protocol was standardized. The first half of the patient sample received end-of-procedure ACP™ injection to the repaired tendon, tuberosity freshening surface and subacromial space, and the second (control) half received no supplementary treatment. The main endpoint was tendon healing on MR arthrography at 6 months according to Sugaya. Secondary endpoints comprised shoulder pain at rest on a numerical scale (0=no pain to 10=worst imaginable pain) and Constant functional score.

Results

Two of the 58 patients refused MR arthrography and 7 were lost to follow-up. Forty-nine patients (26 ACP™, 23 controls) were analyzed: 20 male, 29 female; mean age, 61±7.3 years. There were no significant intergroup differences in healing rate at 6 months (ACP™ 73.1% vs. 78.3% controls; p =0.75), shoulder pain (2±1.8 vs. 2.6±1.7, respectively; p =0.24), or Constant score (77±13.5/100 vs. 72.4±12.3, respectively; p =0.18).

Conclusion

Associating ACP™ did not improve healing after arthroscopic rotator cuff repair. Sample size, however, had been calculated for a large expected difference, leading to lack of power.

Level of evidence

III; case-control study.

The full text of this article is available in PDF format.

Keywords : Rotator cuff tear, Tendon healing, Arthroscopy, Platelet-rich plasma, Autologous Conditioned Plasma (ACP™)




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