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I'm reading everything I can find on-line about platelet-rich plasma therapy for rotator cuff tears. I think this may be the way I want to go IF I have surgery. I notice sometimes they talk about blood injection therapy, sometimes it's platelet-rich plasma, and today I found reference to platelet-rich fibrin matrix. What's the difference among these three things?
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Platelet-rich plasma (PRP) refers to a sample of serum (blood) plasma that has as much as four times more than the normal amount of platelets. This treatment enhances the body’s natural ability to heal itself. It is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries. Platelet-rich plasma is the same as "blood injection therapy."
Platelet-rich fibrin matrix (PRFM) is a variation of platelet-rich plasma. The fibrin matrix processes the patient's plasma in a way that helps keep blood-clotting platelets in the matrix while also slowly releasing cytokines to aid in healing.
Cytokines are signaling molecules used in cellular communication. They are part of the immune system response to injury. They help set up a new blood supply to the area and attract stem cells to the area to help form new tendon.
Surgeons are experimenting a bit with this approach to tendon healing. They are trying to find the best way to use platelet-rich plasma therapy. Tinkering with the "recipe" so-to-speak is one way to improve results. It was hoped that by providing a healing product like PRFM, rotator cuff healing could be accelerated or speeded up. So far, that hasn't been the case.
In a recent study from the Sports Medicine and Shoulder Service at the Hospital for Special Surgery in New York City, the surgeons found that PRFM seemed to inhibit healing. There were more treatment failures in the PRFM group compared with the control group. Although PRFM did not improve rotator cuff tendon healing and was even linked with lower healing rates, further study is needed to understand what happened before either abandoning the technique or using it on other patients.
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