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Biologics for Rotator Cuff Repair: A Critical Analysis Review

Smith, Kevin M., MD1; Le, Adrian D.K., MD1; Costouros, John G., MD1; Dragoo, Jason L., MD1,a

doi: 10.2106/JBJS.RVW.17.00185
Review Articles with Critical Analysis Component
Disclosures

  • * 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.

1Stanford University, Redwood City, California

aE-mail address for J.L. Dragoo: jdragoo@stanford.edu

Copyright © 2018 by The Journal of Bone and Joint Surgery, Incorporated
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