PRP and Rotator Cuff Repair: What New Research Shows

Oct 1

4 min read

Platelet-rich plasma, or PRP, is best known as an in-office injection. It also has a role in the operating room. During arthroscopic surgery, PRP can be applied directly at the repair site, where the body’s healing process is already underway. Rotator cuff repair is one of the most studied examples. This post covers what PRP is, how it is used during surgery, and what a 2026 study found when PRP was added to rotator cuff repair.

What PRP is

PRP is made from your own blood. A small sample is drawn, usually from the arm, and spun in a centrifuge. The spinning separates the blood into layers. The layer with a higher concentration of platelets is collected and prepared for use.

Platelets are best known for clotting, but they also carry growth factors and signaling proteins involved in the body’s repair process. That is the reason PRP has been studied in tendons, ligaments, cartilage, and bone.

Not all PRP is the same

Different systems produce different preparations. Two variables come up most often:

Platelet concentration. How many times higher the platelet count is compared with normal blood.
White blood cell content. Leukocyte-rich PRP keeps more white blood cells. Leukocyte-poor PRP filters most of them out.

These differences matter when reading research. One study’s “PRP” may be a different product from another study’s “PRP”, which makes results hard to compare across papers.

Where PRP is used in orthopedics

In the clinic. PRP can be injected into a joint or around a tendon. Common areas of study include knee osteoarthritis, tennis elbow, and partial tendon tears. These injections are typically done in the office, sometimes with ultrasound guidance.

In the operating room. During arthroscopic surgery, PRP can be applied at the site of a repair. Rotator cuff repair is one of the most studied examples. The surgeon reattaches the torn tendon to the bone, and PRP is placed at the tendon-bone junction as part of the repair.

PRP during rotator cuff repair

A rotator cuff repair reattaches torn tendon to bone. The repair holds the tendon in place, but the long-term result depends on the tendon healing onto the bone over the following months. In some patients, the tendon tears again. This is called a re-tear, and it is one of the main concerns surgeons and patients plan around.

Supporting that tendon-to-bone healing is where PRP comes in. PRP delivers a concentrated dose of the patient’s own platelets and growth factors to the exact spot where healing needs to happen. PRP has been explored as an adjunct to rotator cuff repair for over 15 years, and the research continues to build.

A 2026 study in the journal Arthroscopy added to that research. Surgeons at Yonsei University in Seoul examined PRP combined with bone marrow stimulation in double-row rotator cuff repair. Bone marrow stimulation creates small channels in the bone where the tendon attaches, allowing marrow elements to reach the repair site. The study found lower re-tear rates in the group that received PRP and bone marrow stimulation, while pain and function scores were similar between groups.

An editorial published alongside the study reviewed the wider body of research. It noted that studies and meta-analyses largely suggest PRP, particularly leukocyte-poor formulations, may lower postoperative re-tear rates. It also pointed to differences in how PRP is prepared as a likely reason results vary between studies.

Why the re-tear finding matters

Pain and function scores measure how the shoulder feels and works. Ret-ear rate measures whether the repair itself stays intact. A re-tear can mean ongoing weakness or, for some patients, a second surgery, so the structural integrity of the repair is a central goal of rotator cuff surgery.

The findings also point to preparation as a key factor. PRP varies by system, platelet concentration, and white blood cell content, and the editorial highlighted leukocyte-poor PRP specifically. How PRP is prepared and delivered is part of the surgical plan, just like repair technique and rehab.

The research is still developing. Most studies to date, including this one, are observational, and larger randomized trials will help clarify which patients and tear types are the best candidates.

PRP as part of your repair

If you are planning rotator cuff surgery, ask your surgeon whether PRP could be part of your repair. The answer depends on your tear size and pattern, tendon quality, and overall health, PRP is often not covered by insurance, so cost is part of the conversation too.

Dr. Brett Robin is a board-certified, fellowship-trained orthopedic surgeon specializing in shoulder, knee, hip, and sports medicine. He uses PRP as part of arthroscopic rotator cuff repair when it fits the patient’s plan. He sees patients in Austin and Georgetown. To schedule a visit, call 512-856-1000.

Reference

Chang H-H, Chun Y-M, Kim S-J, Yoon T-H. Platelet-rich plasma and bone marrow stimulation in double-row rotator cuff repair does not improve clinical outcomes but reduces retear rates: a retrospective analysis with propensity score matching. Arthroscopy. 2026;42(7):1103-1113. doi:10.1002/arj.70387