A systematic review and meta-analysis asking whether adding bone marrow stimulation (microfracture or multiple channeling) at the footprint during primary arthroscopic rotator cuff repair improves healing. It pooled 4 comparative studies to compare retear rates and functional scores between BMS and conventional repair.
When you close a rotator cuff repair, the tendon-bone interface heals poorly, and retears stay common despite better anchors and constructs. BMS offers a fast, cheap, low-risk way to bias healing in your favor: drill a few marrow vents in the footprint and let cytokines, growth factors, and MSCs form a super clot at the repair site. This halved the pooled retear rate here (18% vs 32%).
Temper that with the critical appraisal. The significant effect disappeared when only the two RCTs were pooled, so most of the signal came from lower-quality retrospective cohorts graded high risk of bias.
Also know the ceiling of the claim: better structural healing did not improve Constant, DASH, or UCLA scores at short-term follow-up. Retear and clinical outcome correlate poorly early on, though intact tendons tend to do better at 2+ years. Contrast with PRP, which helps only small to medium tears and is cost-ineffective. BMS is the cheaper biological add-on.
A systematic review and meta-analysis asking whether adding bone marrow stimulation (microfracture or multiple channeling) at the footprint during primary arthroscopic rotator cuff repair improves healing. It pooled 4 comparative studies to compare retear rates and functional scores between BMS and conventional repair.
When you close a rotator cuff repair, the tendon-bone interface heals poorly, and retears stay common despite better anchors and constructs. BMS offers a fast, cheap, low-risk way to bias healing in your favor: drill a few marrow vents in the footprint and let cytokines, growth factors, and MSCs form a super clot at the repair site. This halved the pooled retear rate here (18% vs 32%).
Temper that with the critical appraisal. The significant effect disappeared when only the two RCTs were pooled, so most of the signal came from lower-quality retrospective cohorts graded high risk of bias.
Also know the ceiling of the claim: better structural healing did not improve Constant, DASH, or UCLA scores at short-term follow-up. Retear and clinical outcome correlate poorly early on, though intact tendons tend to do better at 2+ years. Contrast with PRP, which helps only small to medium tears and is cost-ineffective. BMS is the cheaper biological add-on.