AccScience Publishing / OTE / Online First / DOI: 10.36922/OTE025320008
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REVIEW ARTICLE

Biological augmentation of arthroscopic repairs: Role of platelet-rich plasma, stem cells, and scaffolds

Kotteda Anil Kumar1* ,  Talari Saikumar1 ,  Akshay Shreegan Ambalal1 ,  Arjit Bansal1 ,  Kankanala Vinay Kumar2
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1 Department of Orthopedic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
2 Department of Orthopedics, All India Institute of Medical Science, Mangalagiri, Andhra Pradesh, India
OTE, 025320008 https://doi.org/10.36922/OTE025320008
Received: 5 August 2025 | Revised: 11 October 2025 | Accepted: 19 November 2025 | Published online: 10 December 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Arthroscopic repair has transformed the management of rotator cuff tears, meniscal lesions, and ligament insufficiency, yet structural failure and incomplete functional recovery remain frequent. Biological augmentation seeks to narrow the gap between mechanical fixation and durable tissue regeneration by delivering concentrated growth factors, multipotent progenitors, and biomimetic matrices directly to the repair site. This narrative review integrates basic science discoveries with translational and clinical data on platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and tissue-engineered scaffolds. A systematic search was conducted on PubMed, Scopus, and Web of Science, and 1829 full-text articles were identified; 23 met the inclusion criteria, and 18 high-quality studies were incorporated in this study. PRP provides an autologous reservoir of anabolic cytokines that accelerate early inflammation resolution and collagen synthesis, with leukocyte-poor formulations showing the most consistent reduction in re-tear rates. MSCs, harvested predominantly from bone marrow or adipose tissue, exert regenerative and immunomodulatory effects through both differentiation and exosomal signaling, enhancing tendon-to-bone integration and meniscal healing in emerging randomized trials. Scaffolds composed of collagen, poly(lactic-co-glycolic acid), or polycaprolactone supply a three-dimensional micro-environment that directs cellular alignment, modulates mechanical load, and can be functionalized with growth factors or gene-activated matrices for sustained bioactivity. Combinatorial approaches—such as MSC-seeded, PRP-soaked scaffolds—demonstrate synergistic improvements in biomechanical strength and histological maturity in pre-clinical models and early clinical cohorts. Standardization of biologic characterization, optimization of delivery timing, and adequately powered, long-term randomized trials remain critical for defining patient-specific algorithms. As regulatory frameworks mature and manufacturing scalability improves, biologically augmented arthroscopic repair is expected to become a routine, precision-oriented component of sports medicine practice.

Keywords
Arthroscopy
Biological augmentation
Platelet-rich plasma
Mesenchymal stem cells
Tissue-engineered scaffold
Rotator cuff repair
Meniscal healing
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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