Biologics for Rotator Cuff Repair: A Critical Analysis Review.

Abstract

* The complexity of tendon to bone healing in a rotator cuff surgical procedure has led to the investigation of biologic augmentation such as platelet-rich plasma, stem cells, and biomaterials to enhance the healing environment and to decrease the prevalence of failure.* Among the many types of biologic augmentation, there is considerable heterogeneity of the content, quality, and quantity of growth factors used in platelet-rich plasma and bone marrow aspirate concentrate, and conclusions from individual studies may not necessarily be generalizable to other formulations within the group.* Current Level-I evidence suggests that universal use of platelet-rich plasma provides no significant clinical benefit in rotator cuff repair.* Although some evidence exists for the use of stem cells from bone marrow aspirate concentrate and the use of biologic grafts, results from Level-I studies are lacking.* Level-I trials focused on the evaluation of clinical outcomes (i.e., American Shoulder and Elbow Surgeons [ASES] score, University of California at Los Angeles [UCLA] shoulder score, Constant score, Simple Shoulder Test) should be performed to help to determine the appropriate use of biologic augmentation in rotator cuff surgical procedures.