Editorial Commentary: Targeted Use of Leukocyte-Poor Platelet-Rich Plasma Reduces Retear Rate More Than Bone Marrow...

Platelet-rich plasma (PRP) has been explored as an adjunct to rotator cuff repair for over 15 years, initially showing reduced retear rates but inconsistent effects on clinical outcomes. Subsequent studies and meta-analyses largely confirm that PRP, particularly leukocyte-poor formulations, may lower postoperative retear rates, while functional and patient-reported outcomes remain largely unaffected. Differences are most likely attributable to variations in PRP composition, underscoring the need for standardized preparation and delivery methods. Recent evidence also indicates that bone marrow stimulation does not consistently improve retear rates or functional outcomes compared with conventional repair. In this context, the literature shows a significantly lower retear rate using PRP versus bone marrow stimulation and standard repair, although clinical outcomes were similar. Cost-effectiveness analyses suggest that PRP is justified when it reduces retear rates by at least 9%, a threshold met in current studies. Overall, the evidence supports the targeted use of leukocyte-poor PRP in rotator cuff tears, with further research needed to clarify biological mechanisms and optimize standardization.