Platelet Rich Fibrin not Effective for enhancing Rotator Cuff Surgery

by Chris Centeno, MD /

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platelet rich fibrin matrix (PRFM)

platelet rich fibrin matrix (PRFM)

Interesting study last month on the use of a specific type of platelet rich plasma-PRFM (platelet rich fibrin matrix), which is more commonly used in surgery. Instead of a cell suspension, PRFM is more like a dense fibrin clot that has platelets embedded inside. In this study, two groups of shoulder rotator cuff repair patients were studied, one where PRFM was used and the other without-no differences in outcomes between the PMRF and usual group were found in this study. My personal take on the research would be that surgical repair for small and medium sized rotator cuff tears isn’t always recommended (which the study authors commented on by saying PRFM might work for larger tears). Another issue with PRFM is you tend to get an unusually dense fibrin matrix (a very thick and dense clot, different from the soft gel that naturally occurs with a blood clot). This dense matrix is a bit more like fibrin glue. The problem with dense clots (like fibrin glue) is that mesenchymal stem cells have difficulty migrating through the clot, and are more likely to perish. Since MSC’s would be the likely cells stimulated by the platelets to enhance repair, the dense clot of PRFM may have worked against these researchers.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
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