RESUMO
Regenerative medicine, specifically bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), has become a novel adjunct that orthopedic surgeons have started to use with surgical rotator cuff repairs (RCR). Thus, we are conducting this systematic review to determine if either RCRs with BMAC alone or with BMAC and PRP result in superior functional outcomes. We conducted a comprehensive search using five databases including PubMed, Web of Science, Embase, Scopus, and Cochrane. After duplicates were removed, 1205 studies were screened by title and abstract using Rayyan, resulting in three included studies (one BMAC with PRP and two BMAC only). Only studies that reported functional outcomes using the American Shoulder and Elbow Surgeons Shoulder Score and the University of California Los Angeles Shoulder Score were included. Changes in assessment scores from baseline to follow-up evaluation were quantified using the effect size and used in the meta-analysis for each group. Interpretation of treatment efficacy was represented using Cohen's d. The effect size of BMAC with PRP (Cohen's d = 2.19) was not significantly different (p = 0.76) from that of BMAC alone (Cohen's d = 2.35). Between-group differences in functional outcomes were Cohen's d = 0.16, which was not significant. Given the lack of superiority and the small sample size, more research is required before a conclusion can be drawn as to the benefits of combining PRP with BMAC for RCR. If functional outcomes are the same, using BMAC alone as an adjunct may be optimal to reduce resources used and cost. Future studies should be conducted with a larger pool as our primary limitation is that only three studies were included.
RESUMO
Aim: To investigate the analyze the relationship between concentration platelet-dose in platelet-rich plasma (PRP) injections and improvements in pain when treating lateral epicondylitis. Methods: A systematic review was conducted into five medical databases, exploring the difference in pain outcomes based on concentration of PRP. Results: Initial querying of the databases yielded 1408 articles with 20 articles ultimately included. There was no statistical significance between effect sizes of the two treatment groups (high and low platelet concentration; p = 0.976). Conclusion: Both large and small concentrations of platelets depict significant reduction in pain, however, between subgroups there was no significance. It can thus be concluded that concentration of platelets in PRP does not impact overall pain relief.
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