Editorial Commentary: Bone Marrow Stimulation Provides Little Benefit for Repair of Full-Thickness Rotator Cuff Tears

Rotator cuff retears remain the most frequently observed complication after arthroscopic cuff repair, with tendon nonhealing rates reported between 20% and 68%. Biological solutions to improve healing rates are needed, and bone marrow stimulation (also known as trephination, microfracture, and crimson duvet) is an elegant solution to improving healing rates, given its efficiency and low cost-if it works. Previous randomized trials have not shown any significant benefit to microfracture in the setting of cuff repair in terms of functional outcomes or healing rates compared with treatment with cuff repair alone. Recent research suggests that healing rates may be improved with bone marrow stimulation. However, strict adherence to definitions of tendon disruption is necessary and when we only consider full-thickness retears, there does not appear to be any clinical benefit to this treatment approach.