Editorial Commentary: Excitement Regarding Commercially Available Exosome Products Is High but Concerns Include...

Exosomes are a subtype of extracellular vesicles. They act as carriers for intercellular communication, transferring molecules between cells and influencing their behavior. They play roles in various physiological processes, including tissue repair. Several basic science studies have evaluated the role of extracellular vesicles in animal models of rotator cuff pathology and have shown potential benefits, including improved structural and biomechanical properties (including greater load to failure, better tendon-to-bone healing, and prevention of muscle atrophy and fatty infiltration). However, clinical studies are lacking, and there are currently no US Food and Drug Administration-approved exosome products. Despite that, exosome products are available to patients, but the information available to them, especially through direct marketing and social media, can lack transparency and be misleading. As the exosome market continues to grow rapidly, it is likely that patients will be seeking information regarding them with increasing frequency. It is therefore important for sports medicine surgeons to understand the evolving landscape for biological augmentation of rotator cuff injuries and provide accurate and evidence-based recommendations to their patients.