human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: HYPOTHESIS Local application of autologous platelet rich plasma ( PRP ) improves tendon healing in patients undergoing arthroscopic rotator cuff repair . STUDY DESIGN Prospect i ve , r and omized , controlled , double blind study ; considering an alpha level of 5 % , a power of 80 % , 22 patients for group are needed . MATERIAL S AND METHODS Fifty-three patients who underwent shoulder arthroscopy for the repair of a complete rotator cuff tear were r and omly divided into 2 groups , using a block r and omization procedure . A treatment group ( N = 26 ) consisted of those who received an intraoperative application of PRP in combination with an autologous thrombin component . A control group ( N = 27 ) consisted of those who did not receive that treatment . Patients were evaluated with vali date d outcome scores . A magnetic resonance image ( MRI ) was performed in all cases at more than 1 year post-op . All patients had the same accelerated rehabilitation protocol . RESULTS The 2 groups were homogeneous . The pain score in the treatment group was lower than the control group at 3 , 7 , 14 , and 30 days after surgery ( P < .05 ) . On the Simple Shoulder Test ( SST ) , University of California ( UCLA ) , and Constant scores , strength in external rotation , as measured by a dynamometer , were significantly higher in the treatment group than the control group at 3 months after surgery ( strength in external rotation [ SER ] : 3 ± 1.6 vs 2.1 ± 1.3 kg ; SST : 8.9 ± 2.2 vs 7.1 ± 2.7 ; UCLA : 26.9 ± 3 vs 24.2 ± 4.9 ; Constant : 65 ± 9 vs 57.8 ± 11 ; P < .05 ) . There was no difference between the 2 groups after 6 , 12 , and 24 months . The follow-up MRI showed no significant difference in the healing rate of the rotator cuff tear . In the subgroup of grade 1 and 2 tears , with less retraction , SER in the PRP group was significant higher at 3 , 6 , 12 , and 24 months postoperative ( P < .05 ) . CONCLUSION The results of our study showed autologous PRP  reduced pain in the first postoperative months . The long-term results of subgroups of grade 1 and 2 tears suggest that PRP positively affected cuff rotator healing Introduction Failure rates after arthroscopic rotator cuff repair remain high . Platelet-rich plasma has gained interest as a potential biological augmentation to enhance bone – tendon healing . The purpose of this study is to evaluate the clinical and structural outcomes of repeated PRP application on rotator cuff repair . Material s and methods Thirty-six patients underwent arthroscopic reconstruction , using knotless anchor double-row repair . Eighteen patients [ 10 female , 8 male ; 61.2 ( ±9.2 ) years ] received two applications of PRP — directly subsequent to the repair and 7 days postoperatively . Eighteen patients [ 11 male , 7 female ; 61.4 ( ±6.5 ) years ] who solely received the same technique of rotator cuff repair were matched for age .  The subjective shoulder value , WORC , and the Constant – Murley score were used for clinical evaluation . MRI was performed for tendon integrity , and cuff appearances were grade d according to the Sugaya classification . Results We prospect ively evaluated the PRP group with a minimum follow-up of 24 months . Clinical results did not show significantly differences in comparison to patients with isolated rotator cuff repair  concerning CS ( 79 ± 13 vs. 77 ± 13 ; P = 0.6 ) , SSV ( 90 ± 14 vs. 88 ± 16 ; P = 0.5 ) or WORC Score ( 90 ± 18 vs. 86 ± 20 ; P = 0.2 ) . At the final follow-up , MRI showed retears in 11 % of the PRP and in 28 % of the control group ( P = 0.4 ) . Conclusions Knotless-anchor double-row repair shows good to excellent clinical results with an acceptable retear rate . Additional two-staged PRP application failed to significantly improve clinical parameters . Even though there was a trend for lower retear rates in the PRP group , it did not achieve statistical difference . Level of evidence Level III , Retrospective comparative study Biological-based therapies for cartilage pathology have gained considerable recognition in the last few decades due to their potential benefits including their minimal invasiveness , capacity for unprecedented healing , and potential for rapid recovery . Consequently , these therapies are likely to have the most noteworthy impact on patients with degenerative joint changes who want to remain active . Currently , the most research ed treatments include platelet-rich plasma ( PRP ) , bone marrow aspirate concentrate ( BMAC ) , and cell-based therapies . Although further basic science research and well- design ed r and omized clinical trials are needed to eluci date the long-term role of these therapies in the treatment of osteoarthritis , there is compelling evidence for their use for certain indications . This article aims to review the existing literature for biological-based treatment options for osteoarthritis , critically assessing the current evidence -based recommendations and identify potential avenues for development Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background : After reinsertion on the humerus , the rotator cuff has limited ability to heal . Growth factor augmentation has been proposed to enhance healing in such procedure . Purpose : This study was conducted to assess the efficacy and safety of growth factor augmentation during rotator cuff repair . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : Eighty-eight patients with a rotator cuff tear were r and omly assigned by a computer-generated sequence to receive arthroscopic rotator cuff repair without ( n = 45 ) or with ( n = 43 ) augmentation with autologous platelet-rich fibrin matrix ( PRFM ) . The primary end point was the postoperative difference in the Constant score between the 2 groups . The secondary end point was the integrity of the repaired rotator cuff , as evaluated by magnetic resonance imaging . Analysis was on an intention-to-treat basis . Results : All the patients completed follow-up at 16 months . There was no statistically significant difference in total Constant score when comparing the results of arthroscopic repair of the 2 groups ( 95 % confidence interval , −3.43 to 3.9 ) ( P = .44 ) . There was no statistically significant difference in magnetic resonance imaging tendon score when comparing arthroscopic repair with or without PRFM ( P = .07 ) . Conclusion : Our study does not support the use of autologous PRFM for augmentation of a double-row repair of a small or medium rotator cuff tear to improve the healing of the rotator cuff . Our results are applicable to small and medium rotator cuff tears ; it is possible that PRFM may be beneficial for large and massive rotator cuff tears . Also , given the heterogeneity of PRFM preparation products available on the market , it is possible that other preparations may be more effective Background : Platelet-rich plasma ( PRP ) is expected to have a biological augmentation potential in the healing of various diseases and injuries , including rotator cuff tears . However , few evaluations have been performed specifically for large to massive tears . Purpose : To assess the efficacy of PRP augmentation in patients undergoing arthroscopic repair for large to massive rotator cuff tears . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : A total of 48 patients scheduled for arthroscopic repair of large to massive rotator cuff tears were r and omly assigned to receive either PRP-augmented ( PRP group ) or conventional treatment ( conventional group ) . In the PRP group , 3 PRP gels ( 3 × 3 mL ) were applied to each patient between the torn end and the greater tuberosity . The primary outcome measure was the retear rate assessed by magnetic resonance imaging ( MRI ) or computed tomographic arthrography ( CTA ) at a minimum of 9 months after surgery . Secondary outcome measures included pain , range of motion , muscle strength , overall satisfaction , functional scores , and the change in cross-sectional area ( CSA ) of the supraspinatus . Results : The retear rate of the PRP group ( 20.0 % ) was significantly lower than that of the conventional group ( 55.6 % ) ( P = .023 ) . Clinical outcomes showed no statistical difference between the 2 groups ( all P > .05 ) except for the overall function ( P = .043 ) . The change in 1-year postoperative and immediately postoperative CSA was significantly different between the 2 groups : –15.54 ± 94.34 mm2 in the PRP group versus −85.62 ± 103.57 mm2 in the conventional group ( P = .047 ) . Conclusion : The application of PRP for large to massive rotator cuff repairs significantly improved structural outcomes , as evidence d by a decreased retear rate and increased CSA of the supraspinatus compared with repairs without PRP augmentation . While there was no significant difference in clinical outcomes except the overall shoulder function after 1-year follow-up , better structural outcomes in the PRP group might suggest improved clinical outcomes at longer term follow-up Background : Two main questions about the use of platelet-rich plasma ( PRP ) for regeneration purpose s are its effect on the speed of healing and the quality of healing . Despite recent numerous studies , evidence is still lacking in this area , especially in a representative patient population with medium to large rotator cuff tears . Purpose : To assess the efficacy of PRP augmentation on the speed and quality of healing in patients undergoing arthroscopic repair for medium to large rotator cuff tears . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : A total of 74 patients scheduled for arthroscopic repair of medium to large rotator cuff tears were r and omly assigned to undergo either PRP-augmented repair ( PRP group ) or conventional repair ( conventional group ) . In the PRP group , 3 PRP gels ( 3 × 3 mL ) were applied to each patient between the torn end and the greater tuberosity . The primary outcome was the Constant score at 3 months after surgery . Secondary outcome measures included the visual analog scale ( VAS ) for pain , range of motion ( ROM ) , muscle strength , overall satisfaction and function , functional scores , retear rate , and change in the cross-sectional area ( CSA ) of the supraspinatus muscle . Results : There was no difference between the 2 groups in the Constant score at 3 months ( P > .05 ) . The 2 groups had similar results on the VAS for pain , ROM , muscle strength , overall satisfaction and function , and other functional scores ( all P > .05 ) except for the VAS for worst pain ( P = .043 ) . The retear rate of the PRP group ( 3.0 % ) was significantly lower than that of the conventional group ( 20.0 % ) ( P = .032 ) . The change in 1-year postoperative and immediately postoperative CSAs was significantly different between the 2 groups : –36.76 ± 45.31 mm2 in the PRP group versus −67.47 ± 47.26 mm2 in the conventional group ( P = .014 ) . Conclusion : Compared with repairs without PRP augmentation , the current PRP preparation and application methods for medium to large rotator cuff repairs significantly improved the quality , as evidence d by a decreased retear rate and increased CSA of the supraspinatus , but not the speed of healing . However , further studies may be needed to investigate the effects of PRP on the speed of healing without risking the quality Background : Increased interest in using platelet-rich plasma ( PRP ) as an augment to rotator cuff repair warrants further investigation , particularly in smaller rotator cuff tears . Purpose : To examine the effectiveness of PRP application in improving perioperative pain and function and promoting healing at 6 months after arthroscopic repair of small- or medium-sized rotator cuff tears . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : This was a double-blinded r and omized controlled trial of patients undergoing arthroscopic repair of partial- or full-thickness rotator cuff tears of up to 3 cm who were observed for 6 months . Patients were r and omized to either repair and PRP application ( study group ) or repair only ( control group ) groups . The patient-oriented outcome measures utilized were the visual analog scale ( VAS ) , the Short Western Ontario Rotator Cuff Index ( ShortWORC ) , the American Shoulder and Elbow Surgeons ( ASES ) form , and the Constant-Murley Score ( CMS ) . Range of motion ( ROM ) and inflammatory and coagulation markers were measured before and after surgery . Magnetic resonance imaging was used at 6 months to assess retear and fatty infiltration rate . Results : Eighty-two patients ( 41 males ) with a mean age of 59 ± 8 years were enrolled ; 41 patients were included in each group . Both the PRP and control groups showed a significant improvement in their pain level based on the VAS within the first 30 days ( P < .0001 ) , with the PRP group reporting less pain than the control group ( P = .012 ) , which was clinical ly significantly different from days 8 through 11 . The PRP group reported taking less painkillers ( P = .026 ) than the control group within the first 30 days . All outcome measure scores and ROM improved significantly after surgery ( P < .0001 ) , with no between-group differences . No differences were observed between groups in inflammatory or co 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: HYPOTHESIS Local application of autologous platelet rich plasma ( PRP ) improves tendon healing in patients undergoing arthroscopic rotator cuff repair . STUDY DESIGN Prospect i ve , r and omized , controlled , double blind study ; considering an alpha level of 5 % , a power of 80 % , 22 patients for group are needed . MATERIAL S AND METHODS Fifty-three patients who underwent shoulder arthroscopy for the repair of a complete rotator cuff tear were r and omly divided into 2 groups , using a block r and omization procedure . A treatment group ( N = 26 ) consisted of those who received an intraoperative application of PRP in combination with an autologous thrombin component . A control group ( N = 27 ) consisted of those who did not receive that treatment . Patients were evaluated with vali date d outcome scores . A magnetic resonance image ( MRI ) was performed in all cases at more than 1 year post-op . All patients had the same accelerated rehabilitation protocol . RESULTS The 2 groups were homogeneous . The pain score in the treatment group was lower than the control group at 3 , 7 , 14 , and 30 days after surgery ( P < .05 ) . On the Simple Shoulder Test ( SST ) , University of California ( UCLA ) , and Constant scores , strength in external rotation , as measured by a dynamometer , were significantly higher in the treatment group than the control group at 3 months after surgery ( strength in external rotation [ SER ] : 3 ± 1.6 vs 2.1 ± 1.3 kg ; SST : 8.9 ± 2.2 vs 7.1 ± 2.7 ; UCLA : 26.9 ± 3 vs 24.2 ± 4.9 ; Constant : 65 ± 9 vs 57.8 ± 11 ; P < .05 ) . There was no difference between the 2 groups after 6 , 12 , and 24 months . The follow-up MRI showed no significant difference in the healing rate of the rotator cuff tear . In the subgroup of grade 1 and 2 tears , with less retraction , SER in the PRP group was significant higher at 3 , 6 , 12 , and 24 months postoperative ( P < .05 ) . CONCLUSION The results of our study showed autologous PRP  reduced pain in the first postoperative months . The long-term results of subgroups of grade 1 and 2 tears suggest that PRP positively affected cuff rotator healing Introduction Failure rates after arthroscopic rotator cuff repair remain high . Platelet-rich plasma has gained interest as a potential biological augmentation to enhance bone – tendon healing . The purpose of this study is to evaluate the clinical and structural outcomes of repeated PRP application on rotator cuff repair . Material s and methods Thirty-six patients underwent arthroscopic reconstruction , using knotless anchor double-row repair . Eighteen patients [ 10 female , 8 male ; 61.2 ( ±9.2 ) years ] received two applications of PRP — directly subsequent to the repair and 7 days postoperatively . Eighteen patients [ 11 male , 7 female ; 61.4 ( ±6.5 ) years ] who solely received the same technique of rotator cuff repair were matched for age .  The subjective shoulder value , WORC , and the Constant – Murley score were used for clinical evaluation . MRI was performed for tendon integrity , and cuff appearances were grade d according to the Sugaya classification . Results We prospect ively evaluated the PRP group with a minimum follow-up of 24 months . Clinical results did not show significantly differences in comparison to patients with isolated rotator cuff repair  concerning CS ( 79 ± 13 vs. 77 ± 13 ; P = 0.6 ) , SSV ( 90 ± 14 vs. 88 ± 16 ; P = 0.5 ) or WORC Score ( 90 ± 18 vs. 86 ± 20 ; P = 0.2 ) . At the final follow-up , MRI showed retears in 11 % of the PRP and in 28 % of the control group ( P = 0.4 ) . Conclusions Knotless-anchor double-row repair shows good to excellent clinical results with an acceptable retear rate . Additional two-staged PRP application failed to significantly improve clinical parameters . Even though there was a trend for lower retear rates in the PRP group , it did not achieve statistical difference . Level of evidence Level III , Retrospective comparative study Biological-based therapies for cartilage pathology have gained considerable recognition in the last few decades due to their potential benefits including their minimal invasiveness , capacity for unprecedented healing , and potential for rapid recovery . Consequently , these therapies are likely to have the most noteworthy impact on patients with degenerative joint changes who want to remain active . Currently , the most research ed treatments include platelet-rich plasma ( PRP ) , bone marrow aspirate concentrate ( BMAC ) , and cell-based therapies . Although further basic science research and well- design ed r and omized clinical trials are needed to eluci date the long-term role of these therapies in the treatment of osteoarthritis , there is compelling evidence for their use for certain indications . This article aims to review the existing literature for biological-based treatment options for osteoarthritis , critically assessing the current evidence -based recommendations and identify potential avenues for development Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background : After reinsertion on the humerus , the rotator cuff has limited ability to heal . Growth factor augmentation has been proposed to enhance healing in such procedure . Purpose : This study was conducted to assess the efficacy and safety of growth factor augmentation during rotator cuff repair . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : Eighty-eight patients with a rotator cuff tear were r and omly assigned by a computer-generated sequence to receive arthroscopic rotator cuff repair without ( n = 45 ) or with ( n = 43 ) augmentation with autologous platelet-rich fibrin matrix ( PRFM ) . The primary end point was the postoperative difference in the Constant score between the 2 groups . The secondary end point was the integrity of the repaired rotator cuff , as evaluated by magnetic resonance imaging . Analysis was on an intention-to-treat basis . Results : All the patients completed follow-up at 16 months . There was no statistically significant difference in total Constant score when comparing the results of arthroscopic repair of the 2 groups ( 95 % confidence interval , −3.43 to 3.9 ) ( P = .44 ) . There was no statistically significant difference in magnetic resonance imaging tendon score when comparing arthroscopic repair with or without PRFM ( P = .07 ) . Conclusion : Our study does not support the use of autologous PRFM for augmentation of a double-row repair of a small or medium rotator cuff tear to improve the healing of the rotator cuff . Our results are applicable to small and medium rotator cuff tears ; it is possible that PRFM may be beneficial for large and massive rotator cuff tears . Also , given the heterogeneity of PRFM preparation products available on the market , it is possible that other preparations may be more effective Background : Platelet-rich plasma ( PRP ) is expected to have a biological augmentation potential in the healing of various diseases and injuries , including rotator cuff tears . However , few evaluations have been performed specifically for large to massive tears . Purpose : To assess the efficacy of PRP augmentation in patients undergoing arthroscopic repair for large to massive rotator cuff tears . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : A total of 48 patients scheduled for arthroscopic repair of large to massive rotator cuff tears were r and omly assigned to receive either PRP-augmented ( PRP group ) or conventional treatment ( conventional group ) . In the PRP group , 3 PRP gels ( 3 × 3 mL ) were applied to each patient between the torn end and the greater tuberosity . The primary outcome measure was the retear rate assessed by magnetic resonance imaging ( MRI ) or computed tomographic arthrography ( CTA ) at a minimum of 9 months after surgery . Secondary outcome measures included pain , range of motion , muscle strength , overall satisfaction , functional scores , and the change in cross-sectional area ( CSA ) of the supraspinatus . Results : The retear rate of the PRP group ( 20.0 % ) was significantly lower than that of the conventional group ( 55.6 % ) ( P = .023 ) . Clinical outcomes showed no statistical difference between the 2 groups ( all P > .05 ) except for the overall function ( P = .043 ) . The change in 1-year postoperative and immediately postoperative CSA was significantly different between the 2 groups : –15.54 ± 94.34 mm2 in the PRP group versus −85.62 ± 103.57 mm2 in the conventional group ( P = .047 ) . Conclusion : The application of PRP for large to massive rotator cuff repairs significantly improved structural outcomes , as evidence d by a decreased retear rate and increased CSA of the supraspinatus compared with repairs without PRP augmentation . While there was no significant difference in clinical outcomes except the overall shoulder function after 1-year follow-up , better structural outcomes in the PRP group might suggest improved clinical outcomes at longer term follow-up Background : Two main questions about the use of platelet-rich plasma ( PRP ) for regeneration purpose s are its effect on the speed of healing and the quality of healing . Despite recent numerous studies , evidence is still lacking in this area , especially in a representative patient population with medium to large rotator cuff tears . Purpose : To assess the efficacy of PRP augmentation on the speed and quality of healing in patients undergoing arthroscopic repair for medium to large rotator cuff tears . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : A total of 74 patients scheduled for arthroscopic repair of medium to large rotator cuff tears were r and omly assigned to undergo either PRP-augmented repair ( PRP group ) or conventional repair ( conventional group ) . In the PRP group , 3 PRP gels ( 3 × 3 mL ) were applied to each patient between the torn end and the greater tuberosity . The primary outcome was the Constant score at 3 months after surgery . Secondary outcome measures included the visual analog scale ( VAS ) for pain , range of motion ( ROM ) , muscle strength , overall satisfaction and function , functional scores , retear rate , and change in the cross-sectional area ( CSA ) of the supraspinatus muscle . Results : There was no difference between the 2 groups in the Constant score at 3 months ( P > .05 ) . The 2 groups had similar results on the VAS for pain , ROM , muscle strength , overall satisfaction and function , and other functional scores ( all P > .05 ) except for the VAS for worst pain ( P = .043 ) . The retear rate of the PRP group ( 3.0 % ) was significantly lower than that of the conventional group ( 20.0 % ) ( P = .032 ) . The change in 1-year postoperative and immediately postoperative CSAs was significantly different between the 2 groups : –36.76 ± 45.31 mm2 in the PRP group versus −67.47 ± 47.26 mm2 in the conventional group ( P = .014 ) . Conclusion : Compared with repairs without PRP augmentation , the current PRP preparation and application methods for medium to large rotator cuff repairs significantly improved the quality , as evidence d by a decreased retear rate and increased CSA of the supraspinatus , but not the speed of healing . However , further studies may be needed to investigate the effects of PRP on the speed of healing without risking the quality Background : Increased interest in using platelet-rich plasma ( PRP ) as an augment to rotator cuff repair warrants further investigation , particularly in smaller rotator cuff tears . Purpose : To examine the effectiveness of PRP application in improving perioperative pain and function and promoting healing at 6 months after arthroscopic repair of small- or medium-sized rotator cuff tears . Study Design : R and omized controlled trial ; Level of evidence , 1 . Methods : This was a double-blinded r and omized controlled trial of patients undergoing arthroscopic repair of partial- or full-thickness rotator cuff tears of up to 3 cm who were observed for 6 months . Patients were r and omized to either repair and PRP application ( study group ) or repair only ( control group ) groups . The patient-oriented outcome measures utilized were the visual analog scale ( VAS ) , the Short Western Ontario Rotator Cuff Index ( ShortWORC ) , the American Shoulder and Elbow Surgeons ( ASES ) form , and the Constant-Murley Score ( CMS ) . Range of motion ( ROM ) and inflammatory and coagulation markers were measured before and after surgery . Magnetic resonance imaging was used at 6 months to assess retear and fatty infiltration rate . Results : Eighty-two patients ( 41 males ) with a mean age of 59 ± 8 years were enrolled ; 41 patients were included in each group . Both the PRP and control groups showed a significant improvement in their pain level based on the VAS within the first 30 days ( P < .0001 ) , with the PRP group reporting less pain than the control group ( P = .012 ) , which was clinical ly significantly different from days 8 through 11 . The PRP group reported taking less painkillers ( P = .026 ) than the control group within the first 30 days . All outcome measure scores and ROM improved significantly after surgery ( P < .0001 ) , with no between-group differences . No differences were observed between groups in inflammatory or co 
    Output:
    