Arthroscopic PRP gel augmentation at the tendon-bone interface accelerates functional recovery and structural healing in rotator cuff repair - a retrospective cohort study

Q: What was the main objective of this retrospective cohort study?

To evaluate whether intraoperative platelet-rich plasma (PRP) gel applied at the tendon-bone interface during arthroscopic rotator cuff repair enhances functional recovery, reduces pain, and improves tendon healing within 6 months postoperatively.

Q: How were patients treated in the PRP group versus the control group?

The PRP group (n=91) received thrombin-activated PRP gel injected at the tendon-bone interface under direct arthroscopic visualization, while the control group (n=61) received standard repair alone.

Q: What improvements were observed at 6 months after surgery?

Compared with controls, the PRP group showed greater improvements in functional outcomes (CMS, ASES, SSV), greater pain reduction (VAS), and MRI tendon healing results favoring PRP, including a higher proportion of favorable Sugaya grades and lower retear rates.

Sep 30, 2026

Uploaded by ahduag

Arthroscopic rotator cuff repair often faces persistent pain, delayed tendon healing, and retear risk during the first six months, a period linked to functional reintegration and ERAS goals. This retrospective cohort study evaluated whether intraoperative platelet-rich plasma (PRP) gel placed at the tendon-bone interface improves recovery, reduces pain, and enhances tendon healing. Outcomes were assessed preoperatively and at six months using CMS, ASES, SSV, VAS, and MRI-based Sugaya classification. Results showed improved functional recovery and structural healing with reduced retear tendency in the PRP group.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusion

Introduction

Background and clinical problem

PRP rationale and controversies

Zhang et al. BMC Musculoskeletal Disorders (2026) 27:12 [https://doi.org/10.1186/s12891-025-09366-5](https://doi.org/10.1186/s12891-025-09366-5) BMC Musculoskeletal Disorders RESEARCH Open Access Arthroscopic PRP gel augmentation at the tendon-bone interface accelerates functional recovery and structural healing in rotator cuff repair: a retrospective cohort study Jian-min Zhang 1†, Li Ying 1†, Li-wei Ying 1, Yong-zhi Ye 1, Yang Yang 1, Xiao-bo Zhou 1* and Qing-guo Zhang 1* Abstract Objective This study aimed to evaluate whether intraoperative application of platelet-rich plasma (PRP) gel atthe tendon-bone interface during arthroscopic rotator cuff repair enhances functional recovery, reduces pain, and improves tendon healing within the critical 6-month postoperative window—a pivotal period for retear risk, socioeconomic reintegration, and ERAS (Enhanced Recovery After Surgery) outcomes. Methods In this retrospective cohort study, 152 patients with full-thickness supraspinatus tears underwent arthroscopic repair. The PRP group (n = 91) received thrombin-activated PRP gel injected at the tendon-bone interface under direct arthroscopic visualization, while controls (n = 61) received standard repair alone. Functional outcomes (Constant-Murley Score [CMS], American Shoulder and Elbow Surgeons [ASES] score, Subjective Shoulder Value [SSV]) and pain (Visual Analog Scale [VAS]) were assessed preoperatively and at 6 months postoperatively. Tendon healing was evaluated via MRI using Sugaya classification and tendon thickness measurement. Results At 6 months postoperatively, the PRP group demonstrated significantly greater improvements in all outcomes versus controls: Functional recovery: ΔCMS = 23.33 vs. 13.08 (p < 0. 01); ΔASES = 45.56 vs. 38.78 (p < 0. 01); SSV = 82 . 97% vs. 78. 85%(p = 0 . 006); Pain reduction: ΔVAS = 3.97 vs. 3.51 (p < 0. 01); Tendon healing: Sugaya grade distribution significantly favored the PRP group (p < 0. 001), with 89 . 0% vs. 54. 1% achieving favorable healing (I/II) and lower retear rates (IV/V: 2. 2% vs. 13. 1%); tendon thickness 0.63 ± 0.08 cm vs. 0.50 ± 0.06 cm (p < 0. 001) . Conclusion PRP gel application was associated significantly greater improvement in functional recovery, greater reduction in pain, and better structural healing at 6 months postoperatively. This approach may support the †Jian-min Zhang and Li Ying contributed equally to this work and share first authorship. Qing-guo Zhang and Xiao-bo Zhou are cocorresponding authors. *Correspondence: Xiao-bo Zhou [zhouxiaobo@enzemed.com](zhouxiaobo@enzemed.com)[ ](zhouxiaobo@enzemed.com)Qing-guo Zhang [zhangqg@enzemed.com](zhangqg@enzemed.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Zhang et al. BMC Musculoskeletal Disorders (2026) 27:12 Page 2 of 11 objectives of enhanced recovery pathways by potentially facilitating a ti

FAQs

What was the main objective of this retrospective cohort study?

To evaluate whether intraoperative platelet-rich plasma (PRP) gel applied at the tendon-bone interface during arthroscopic rotator cuff repair enhances functional recovery, reduces pain, and improves tendon healing within 6 months postoperatively.

How were patients treated in the PRP group versus the control group?

The PRP group (n=91) received thrombin-activated PRP gel injected at the tendon-bone interface under direct arthroscopic visualization, while the control group (n=61) received standard repair alone.

What improvements were observed at 6 months after surgery?

Compared with controls, the PRP group showed greater improvements in functional outcomes (CMS, ASES, SSV), greater pain reduction (VAS), and MRI tendon healing results favoring PRP, including a higher proportion of favorable Sugaya grades and lower retear rates.

Sep 30, 2026

Uploaded by ahduag