ORTHOBIOLOGIC AND ROBOTIC INNOVATIONS FOR TENDON-TO-BONE HEALING IN CHRONIC ROTATOR CUFF TEARS

Abstract

Chronic rotator cuff tears are a clinical challenge due to chronic inflammation, progressive tendon degeneration, impairment in regeneration and fatty infiltration. High retear rates, particularly in chronic and large tears, highlight the limitations of mechanical repair alone. These limitations highlight the need for methods that can solve the biomechanical stability and the biological deficits that compromise healing. Orthobiologics utilise allogeneic and autologous substances derived from human cells and tissues to promote pain relief, tissue healing and enhance functioning through anti inflammatory effect. Current strategies include platelet rich plasma injection, bone marrow aspiration injections and mesenchymal stem cell therapy. Biologic augmentation is aimed at improving clinical outcomes and healing rates in rotator cuff repair. Robotics enhances the effectiveness of biologic augmentation by creating a mechanically optimized environment for healing. Robotic and navigation-assisted technologies support improved surgical precision, anchor placement accuracy, footprint restoration, and control of tendon tension. Technologies like three-dimensional imaging and artificial intelligence allow targeted biologic release and customised surgical plans for each individual. Comparing preclinical studies and clinical outcomes remains inconsistent, largely due to variability in biologic preparation, patient related factors such as their chronic condition and tissue quality. In chronic rotator cuff repair, orthobiologics and robotics show an advanced approach in the clinical treatments. Future studies and clinical trials will be critical to confirm and proceed these advanced treatment goals.