Enhancing SLAP repairs with Fibrin-PRP clots - Poster
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Poster at the American Orthopaedic Society for Sports Medicine Annual Meeting 2009 - Enhancing SLAP repairs with Fibrin-PRP clots
![Enhancing SLAP Repairs with Fibrin-PRP Clots
Alan M Hirahara MD FRCSC1, Kyle Yamashiro PT2, Russell Dunning MPT 2
1 - Private Practice, Sacramento, CA / 2 - Results Physical Therapy, Sacramento, CA
INTRODUCTION PATIENT DEMOGRAPHICS
• In the literature, 20% non-healing of SLAP repairs reported [1]. Control Group Study Group
• Fibrin clots – Improved healing with meniscal repairs but technically • 39 patients • 139 patients
challenging with arthroscopy [2]. • 23 male (59%), 16 female • 85 male (61%), 54 female
• Age range: 18 – 66 years • Age range: 13 – 77 years
• Platelet-Rich Plasma (PRP) – Improved healing of soft tissues & bone [3]. • Age average: 43.09 years
• Age average: 45.80 years
STUDY DESIGN
STUDY RESULTS
• Case-Control analysis of 180 patients, collected 1/07 – 12/08
• Same surgeon, same therapy group Pain Scores ASES Scores
• Inclusions: All SLAP repairs / Exclusions: Any post-op trauma
p = NS p = NS p < 0.001 p < 0.05 p = NS p < 0.05 p < 0.001 p = 0.06
7.1 81.9
8.0 7.1 90.0
72.7
• Failure to heal: Evaluated any symptoms 4-6 months post-op with repeat MRA
71.0
80.0
7.0 6.0
5.2 70.0
6.0 56.3
or surgery
4.8
60.0
5.0 45.2
43.1
50.0
35.9 36.9
4.0 3.0 3.1
40.0
3.0
1.7 30.0
APPLICATION OF FIBRIN-PRP CLOT
2.0
20.0
1.0 10.0
0.0 0.0
Pre-op 1 Month 3 Month 6 Month Pre-op 1 Month 3 Month 6 Month
60 ml blood from patient pre-operatively
Platelet Poor Plasma Control Group Study Group Control Group Study Group
(PPP)
Platelet Rich Plasma (PRP)
Statistically significant: Failures
Red Blood Cells
Blood centrifuged for 8 minutes using a
p = 0.008
p = 0.008
- Improved pain scores by 3 months
platelet concentration system* 12.00% 10.26%
- Improved ASES scores by 3 months 10.00%
4/39
- Improved time to discharge by 94.4 days
8.00%
Fibrin-PRP mixture created 3:1 ratio
6.00%
- Improved return to work by 64.6 days 4.00%
0.72%
- Improved failure rate from 10.3% to 0.7%
2.00%
1/139
0.00%
Control Group Study Group
Suture anchors# placed & sutures
passed CONCLUSIONS
• Fibrin-PRP clots enhance SLAP repairs:
Fibrin-PRP clot placed in-situ
• Reliable, Improved Healing
arthroscopically
• Fewer Revisions
• Less Pain REFERENCES
1. Snyder, S. J Arthroscopy & Related Surg 1990;6:274-9.
Sutures tied with clot between glenoid & • Faster Recovery 2. Arnoczky, S. JBJS 1988;70:1209-17.
labrum 3. Marx, R. J Oral Maxfac Surgery 2004;62:489-96.
* Plasmax PlusTM , Biomet Biologics
# BioSutureTakTM, Arthrex](https://image.slidesharecdn.com/prpslap-aossm-poster2009-120729171729-phpapp01/85/Enhancing-SLAP-repairs-with-Fibrin-PRP-clots-Poster-1-320.jpg)
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Enhancing SLAP repairs with Fibrin-PRP clots - Poster
- 1. Enhancing SLAP Repairs with Fibrin-PRP Clots Alan M Hirahara MD FRCSC1, Kyle Yamashiro PT2, Russell Dunning MPT 2 1 - Private Practice, Sacramento, CA / 2 - Results Physical Therapy, Sacramento, CA INTRODUCTION PATIENT DEMOGRAPHICS • In the literature, 20% non-healing of SLAP repairs reported [1]. Control Group Study Group • Fibrin clots – Improved healing with meniscal repairs but technically • 39 patients • 139 patients challenging with arthroscopy [2]. • 23 male (59%), 16 female • 85 male (61%), 54 female • Age range: 18 – 66 years • Age range: 13 – 77 years • Platelet-Rich Plasma (PRP) – Improved healing of soft tissues & bone [3]. • Age average: 43.09 years • Age average: 45.80 years STUDY DESIGN STUDY RESULTS • Case-Control analysis of 180 patients, collected 1/07 – 12/08 • Same surgeon, same therapy group Pain Scores ASES Scores • Inclusions: All SLAP repairs / Exclusions: Any post-op trauma p = NS p = NS p < 0.001 p < 0.05 p = NS p < 0.05 p < 0.001 p = 0.06 7.1 81.9 8.0 7.1 90.0 72.7 • Failure to heal: Evaluated any symptoms 4-6 months post-op with repeat MRA 71.0 80.0 7.0 6.0 5.2 70.0 6.0 56.3 or surgery 4.8 60.0 5.0 45.2 43.1 50.0 35.9 36.9 4.0 3.0 3.1 40.0 3.0 1.7 30.0 APPLICATION OF FIBRIN-PRP CLOT 2.0 20.0 1.0 10.0 0.0 0.0 Pre-op 1 Month 3 Month 6 Month Pre-op 1 Month 3 Month 6 Month 60 ml blood from patient pre-operatively Platelet Poor Plasma Control Group Study Group Control Group Study Group (PPP) Platelet Rich Plasma (PRP) Statistically significant: Failures Red Blood Cells Blood centrifuged for 8 minutes using a p = 0.008 p = 0.008 - Improved pain scores by 3 months platelet concentration system* 12.00% 10.26% - Improved ASES scores by 3 months 10.00% 4/39 - Improved time to discharge by 94.4 days 8.00% Fibrin-PRP mixture created 3:1 ratio 6.00% - Improved return to work by 64.6 days 4.00% 0.72% - Improved failure rate from 10.3% to 0.7% 2.00% 1/139 0.00% Control Group Study Group Suture anchors# placed & sutures passed CONCLUSIONS • Fibrin-PRP clots enhance SLAP repairs: Fibrin-PRP clot placed in-situ • Reliable, Improved Healing arthroscopically • Fewer Revisions • Less Pain REFERENCES 1. Snyder, S. J Arthroscopy & Related Surg 1990;6:274-9. Sutures tied with clot between glenoid & • Faster Recovery 2. Arnoczky, S. JBJS 1988;70:1209-17. labrum 3. Marx, R. J Oral Maxfac Surgery 2004;62:489-96. * Plasmax PlusTM , Biomet Biologics # BioSutureTakTM, Arthrex