Journal of Orthopaedic Surgery and Research · IF 2.8 · August 22, 2026 · LoE II
Bone marrow stimulation in arthroscopic rotator cuff repair: a meta-analysis
Simone Cerciello, Fabrizio Mocini, Erminia Cofano, Vincenzo Mattiacci, Michele Mercurio — Casa di Cura Città di Roma
This meta-analysis pooled 15 comparative studies (1552 patients) comparing arthroscopic rotator cuff repair (ARCR) with versus without bone marrow stimulation (BMS, e.g. microfracture or marrow venting of the greater tuberosity). Overall, adding BMS was associated with a lower retear rate (14% vs 18%, OR 0.69, 95% CI 0.51-0.92, p=0.01), an effect driven mainly by single-row repairs (16% vs 27%, p=0.0002), while the double-row subgroup showed a similar trend that was not statistically significant (11% vs 16%, p=0.07). Postoperative ASES and Constant-Murley scores and forward elevation were modestly better with BMS, but simple shoulder test, UCLA score, VAS pain, and rotation were unchanged between groups.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersRetear after rotator cuff repair remains common, and this synthesis suggests a cheap, autologous biologic augmentation (marrow venting) may reduce retear risk, particularly when using single-row fixation, which is clinically relevant for surgeons deciding whether to add BMS during ARCR.
Conclusion strengthConfirms prior evidence
Two or more critical methodological failures for a review.
Presenting this at rounds? Start here
- ?Should surgeons preferentially add bone marrow stimulation when performing single-row rather than double-row rotator cuff repairs, given the differential retear benefit seen here?
- ?Given the marginal functional score differences (ASES +1.6, CMS +2.5 points) versus reported MCIDs, should BMS be adopted primarily to reduce retear risk rather than to improve patient-reported function?