Biologic Augmentation of Rotator Cuff Repair

Rotator cuff tears are a common orthopaedic injury, affecting a substantial proportion of the population. Over the past two decades, surgical management of rotator cuff tears has evolved considerably, resulting in notable improvements in patient outcomes. Despite these advancements, retear rates remain a significant challenge for orthopaedic surgeons, prompting the development of techniques to augment rotator cuff repair (RCR). Using biologic agents, RCR can be augmented to improve long-term outcomes by increasing healing and durability. To evaluate the current landscape of biologic augmentation in RCR, a comprehensive literature review was conducted. This review describes the primary biologic augmentation modalities, including platelet-rich plasma, bone marrow-derived biologics, grafts, and bio-inductive patches, and examines their reported clinical outcomes and limitations to support informed clinical decision-making. Although biologic augmentation has demonstrated promising advancements and improved patient outcomes, further high-quality prospective randomized studies are necessary to standardize practice, given the variability in existing evidence.