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ARTHROSCOPIC REPAIR PROTOCOL FOR MASSIVE ROTATOR CUFF TEARS AUGMENTED WITH PLATELET - RICH FIBRIN
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Abstract
Objective: To present the arthroscopic repair protocol for massive rotator cuff tears augmented with platelet-rich fibrin (PRF), aiming to optimize the biological environment at the tendon–bone interface and enhance healing potential. Background: Massive rotator cuff tears have a high retear rate due to poor tendon quality and limited intrinsic healing capacity at the tendon–bone junction. Autologous PRF provides a stable fibrin matrix enriched with growth factors (TGF-β1, PDGF, VEGF, FGF, IGF, EGF), promoting angiogenesis, fibroblast differentiation, and improved tendon–bone healing after repair. Methods/Technique: This article describes the step-by-step surgical workflow including autologous PRF preparation, intra-articular assessment of the tear, footprint preparation, anchor placement, PRF application at the tendon–bone interface, and arthroscopic rotator cuff repair technique. Clinical significance: PRF augmentation during repair of massive rotator cuff tears is expected to enhance the local biological microenvironment, promote early neovascularization, reduce retear rates, and improve postoperative functional outcomes compared with conventional techniques. Conclusion: Arthroscopic repair of massive rotator cuff tears with PRF augmentation is a feasible, safe, and biologically promising technique. The standardized protocol provided in this article facilitates practical adoption by orthopedic surgeons
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Keywords
massive rotator cuff tear, platelet-rich fibrin.
References
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