Optimising methodology, biomechanics and imaging in biological augmentation for partial-thickness rotator cuff tears: A commentary on Demiral et al

Platelet-rich plasma (PRP) combined with physical therapy (PT) represents a growing paradigm in the nonoperative management of partial-thickness rotator cuff tears (PTRCTs). In a recent publication in Knee Surgery, Sports Traumatology, Arthroscopy, Demiral et al. reported significant clinical and radiological improvements following PRP supplementation in articular-sided partial supraspinatus tears. While their findings provide encouragement for biologic augmentation, several methodological nuances warrant deeper examination. This commentary provides a broader critical perspective on three essential domains: baseline functional comparability and statistical model selection, the biological-biomechanical interface during early rehabilitation loading, and radiological precision in magnetic resonance arthrography (MRA) tear volume estimation. By addressing these methodological challenges, we aim to offer actionable guidance for future clinical trial designs and therapeutic protocols in sports medicine and orthopaedic rehabilitation. LEVEL OF EVIDENCE: NA.