Graft augmentation during rotator cuff repair cuts retear rates more effectively than PRP alone because it provides structural support rather than just temporary cellular factors. Large studies show the benefit, and combining grafts with PRP or bone-marrow concentrate may help further, especially for massive tears.
So what do we know about this topic? We know that if you add graft augmentation, based on large studies, systematic review here, you have lower retear rate with the use of augmentation. And at least in this systematic review or meta-analysis, that impact was greater than PRP, which makes sense because you're adding a scaffold, not just cells that can disperse really quickly and go away in a short period of time. Unfortunately, they haven't really been well studied together. But it makes sense to me that these are addressing different factors. So if somebody has a large tear or massive tear, it's worthwhile considering PRP or BMAC cells in addition to tissue augmentation.
