Here are their conclusions regarding platelet rich plasma (PRP). Given the wide variety of clinical results for PRP injections for various shoulder pathologies, expectations must be tempered by clinicians and patients. Although basic science literature supports a potential role in the management of rotator cuff tears, robust clinical data are lacking to support their widespread use.
Here are their conclusions regarding "stem cells" or "cell based therapy" or Bone marrow aspirate concentrate (BMAC). BMAC has the unique advantage of containing a very small population of mesenchymal stem cells and a high proportion of various growth factors, but its true clinical efficacy is still largely unknown. High-quality studies with appropriate control groups are needed to better define its clinical role. A critical deficiency in the current literature is the lack of information correlating the composition and/or biologic activity of marrow-derived cells and clinical outcomes. Furthermore, obtaining BMAC is an expensive procedure with unknown cost-effectiveness.
One of the key issues is the direct to consumer advertising of stem cell and related therapies See this link.
Comment: Currently we are seeing aggressive marketing and patient demand that has led to the indiscriminate use of cell therapy for a wide range of musculoskeletal conditions. It is of note that in many cases the high cost of these procedures is covered by the patient because insurance companies have not been convinced of their effectiveness. Because of the lack of data on their value to the patient, we avoid these interventions in our patients.
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