Rotator Cuff Repair: A Biological Approach to Improve Outcomes

Biologic agents are increasingly being used within the field of orthoapedic surgery to treat a variety of musculoskeletal conditions. Most agents attempt to stimulate or manipulate the local cellular environment to increase the innate healing response. This is especially appealing for the management of rotator cuff disease, since most pathology is secondary to chronic, degenerative changes within the rotator cuff tendon. The most commonly used biologic agents in the management of rotator cuff disease are platelet-rich plasma, cell-based approaches using bone marrow or adipose-derived progenitor cells, and extracellular matrix “patches.” The past decade has seen a substantial increase in demand for these agents, yet data to support their use are currently limited. Physicians must remain well educated about these agents as new information becomes available. The following chapter offers background and review of the literature for the most commonly used biologic agents in the management of rotator cuff disease.