Biologic Augmentation of Rotator Cuff Repair: PRP May Be of Significant Benefit, Whereas Atelocollagen Can Not Be Recommended.

The field of orthobiologics continues to advance at a rapid pace, and theoretically holds some promise to augment the biologic healing response in rotator cuff repair. However, the clinical evidence for use of substances such as platelet-rich plasma for rotator cuff repair remains inconclusive. Atelocollagen, as a synthetic collagen substitute, has been proposed as another alternative to provide more collagen substrate for healing, but outcomes data with this technique is lacking. As biologic augmentation options continue to push the envelope on indications, due diligence is required to carefully examine options for safety and efficacy. Evolutions in rotator cuff repair should also continue to motivate sports medicine surgeons and researchers to seek out further innovations to improve patient outcomes. In contrast, (biologic) platelet rich plasma (PRP) has been well-studied, does not show adverse outcomes, and has been shown to improve healing of large-to-massive tears as well as RCR outcomes. That said, PRP outcome improvement for RCR is not definitive and requires further study. RCR can humble even the best of surgeons, and demands that we continue to look for ways to improve outcomes.