Biologic Augmentation of Rotator Cuff Repair: The Role of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate

Rotator cuff tears are common and can be a debilitating problem for patients, leading to pain, difficulty sleeping, and poor function. Although in many cases, patients can be managed non-operatively, surgery is required for a subset of patients. Even with advances in surgical techniques and implants, postoperative re-tear rates range from 15%-40%. Thus, surgical approaches to manage rotator cuff tears must be optimized to improve clinical outcomes and reduce failure rates. The incorporation of biologic agents to the repair construct has been increasingly described over the past decade, and appears to be a promising potential augmentation to standard repair techniques. Biologic agents such as platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) are obtained from the patient at the time of rotator cuff repair (RCR), and are added to the repair construct to improve the likelihood of tendon healing. This review will describe the utilization of biologic agents, including PRP and BMAC, during RCR, with an emphasis on techniques and outcomes. Given the paucity of literature describing long-term outcomes with any biologic agent as an augmentation to RCR, additional research is needed to better understand the long-term impact of these agents.