Fibrin Scaffold as a Carrier for Mesenchymal Stem Cells and Growth Factors in Shoulder Rotator Cuff Repair.

With an increase in the aging population, rotator cuff tears are becoming more common. High failure rates with shoulder rotator cuff repair surgery have been persistent, prompting the introduction of biologic methods to promote healing. The aim of the present technique is to deliver stem cells and growth factors to the footprint of the repair site. A platelet-rich plasma (PRP) fibrin clot is used as a scaffold for the delivery of stem cells, by using PRP, to provide a source of growth factors, and platelet-poor plasma (PPP) as a source for fibrinogen for the matrix for the scaffold. In the second step, bone marrow is harvested from the proximal humerus, concentrated, and combined with the PRP and PPP. Using a customized device, we then activate the clotting process and transfer the scaffold containing the stem cells using a suture anchor onto the shoulder rotator cuff footprint. In an effort to promote healing, this technique reimplants autologous stem cells and growth factors into the operative site. This technique may serve as an alternative for typically used scaffolds such as collagen matrices or decellularized human dermis patches.