Rationale for Biologic Augmentation of Rotator Cuff Repairs
This study reviews the current evidence surrounding rotator cuff repairs (RCR). Rotator cuff tears are a frequent cause of shoulder pain and disability; despite resolution of pain and outcome measures following surgery, incomplete healing or re-tearing following surgery is often noted. Specifically, failures can occur early at the suture-tendon interface or later due to delayed healing of the rotator cuff. The suture-tendon interface can be augmented with dermal allografts (ADMs) and healing of the tendon can be expedited using biologics agents. Platelet-rich plasma (PRP) has gained interest for use during surgery. Several studies have reported improved tendon healing rates after RCR; however, some studies have also reported no benefit. The inconsistency may stem from variable techniques used to prepare and deliver PRP. Bone marrow aspirate concentrate (BMAC) is another biologic agent that has been in use with RCRs. One high-quality study reported all patients who received BMAC had improved tendon healing rates and no re-tears. The authors of the study report that biologics have the potential to improve tendon healing after RCR, but additional studies are needed to determine clinical applications.