Factors affecting rotator cuff tendon healing after arthroscopic repair augmented with platelet-rich fibrin in large rotator cuff tears: A prognostic study

Abstract

Objective: To identify preoperative prognostic factors associated with tendon-to-bone healing after arthroscopic repair of large rotator cuff tears augmented with platelet-rich fibrin (PRF).

Methods: A prospective study enrolled patients with large rotator cuff tears (3–5 cm) who underwent arthroscopic suture‑bridge repair with PRF augmentation. Preoperative clinical data, MRI findings, and intraoperative factors were analysed against 6‑month postoperative MRI tendon integrity (Sugaya classification). Univariate and multivariate logistic regression identified independent predictors.

Results: Of 60 patients, 15 (25.0%) had a retear at 6 months. Univariate analysis showed that age, infraspinatus fatty infiltration grade 2, supraspinatus occupation ratio, infraspinatus occupation ratio, acromiohumeral distance, and inferoglenohumeral distance were significantly associated with retear. In multivariate analysis, only the supraspinatus occupation ratio remained an independent protective factor (OR = 0.70 per 1% increase; 95% CI: 0.51–0.94; p = 0.018). The model’s small event number (15 retears) limits precision; findings are exploratory.

Conclusion: Preoperative supraspinatus occupation ratio on MRI is an independent prognostic factor for tendon healing after arthroscopic PRF‑augmented repair of large rotator cuff tears. Larger validation studies are needed.