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Review
. 2025 Jun 5;12(6):617.
doi: 10.3390/bioengineering12060617.

Leukocyte-Rich Platelet-Rich Plasma's Clinical Effectiveness in Arthroscopic Rotator Cuff Repair: A Meta-Analysis of Randomized Controlled Trials

Peiyuan Tang  1   2 , Meihui Huang  3 , Wenfeng Xiao  1   2 , Ting Wen  1   2 , Pavel Volotovsky  4 , Mikhail Gerasimenko  4 , Shiyao Chu  4 , Shuguang Liu  5 , Kai Zhang  6 , Yusheng Li  1   2
Affiliations
Review

Leukocyte-Rich Platelet-Rich Plasma's Clinical Effectiveness in Arthroscopic Rotator Cuff Repair: A Meta-Analysis of Randomized Controlled Trials

Peiyuan Tang et al. Bioengineering (Basel). .

Abstract

Background: Arthroscopic rotator cuff repair faces high retear risks in multi-tendon injuries due to insufficient biological healing; leukocyte-rich PRP may enhance tendon-bone integration through inflammatory modulation and growth factor release. Methods: Four databases including PubMed, Embase, Cochrane Library, and Web of Science were searched until March 2025. Literature screening, quality evaluation, and data extraction were performed according to inclusion and exclusion criteria. GRADE was used to grade the strength of the evidence and the results. Results: The main finding of this study was that leukocyte-rich platelet-rich plasma combined with arthroscopic surgery for rotator cuff injuries can improve the Constant Score (MD = 1.13, 95% CI: 0.19, 2.07, p = 0.02, I2 = 47%), American Shoulder and Elbow Surgeons score (MD = 6.02, 95% CI: 4.67, 7.36, p < 0.01, I2 = 0%), and University of California, Los Angeles score (MD = 1.20, 95% CI: 0.34, 2.06, p < 0.01, I2 = 0%) of patients with rotator cuff tear after treatment, and reduce the postoperative Visual Analog Scale score (MD = -0.62, 95% CI: -1.16, -0.08, p = 0.02, I2 = 83%) of patients. However, there were no statistical differences regarding the Simple Shoulder Test (MD = 0.08, 95% CI: -0.23, 0.39, p = 0.61, I2 = 5%). Conclusions: Based on current evidence, the use of LR-PRP in arthroscopic rotator cuff repair could lessen postoperative pain and improve postoperative functional scores in individuals with rotator cuff injuries.

Keywords: leukocyte-rich; meta-analysis; platelet-rich plasma; rotator cuff; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram is provided to show study selection.
Figure 2
Figure 2
A figure displaying the risk of bias for each of the included randomized studies. The color represents the quality in each of the domains (red = high risk, yellow = uncertain, and green = low risk) [19,20,21,22,23,24].
Figure 3
Figure 3
GRADE evidence for outcomes of rotator cuff tears treated with LR-PRP. Platelet-rich plasma (PRP); Leukocyte-rich (LR); Constant Score (CS); Visual Analog Scale (VAS); American Shoulder and Elbow Surgeons score (ASES); University of California, Los Angeles score (UCLA); Simple Shoulder Test (SST). 1 I2 > 75%; 2 The sample size is relatively small.
Figure 4
Figure 4
Forest plot of Constant Score outcomes: meta-analysis of LR-PRP vs. control groups using random-effect model [19,20,21,22,23,24].
Figure 5
Figure 5
Forest plot of Visual Analog Scale (VAS) pain outcomes: LR-PRP vs. control interventions with high heterogeneity [20,21,23,24].
See this image and copyright information in PMC

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