DURABLE 8-YEAR CLINICAL AND STRUCTURAL OUTCOMES FOLLOWING ULTRASOUND-GUIDED AUTOLOGOUS BONE MARROW ASPIRATE CONCENTRATE INJECTION FOR PARTIAL-THICKNESS SUPRASPINATUS TEARS

Don Buford, MD, William Murrell, MD — Wed, 22 Jul 2026 00:00:00 +0000

Background: Partial-thickness rotator cuff tears (pRCTs) are among the most common causes of shoulder pain and disability in adults. Conventional nonoperative care—physical therapy, NSAIDs, and corticosteroid injection—relieves symptoms but does not restore tendon integrity. Bone marrow aspirate concentrate (BMAC) may provide a biologically active stimulus for structural tendon repair, yet long-term outcome data for BMAC injection without concurrent surgery are lacking.
Objective: To evaluate the durability of clinical and structural outcomes at a minimum of 7 years following ultrasound-guided autologous BMAC injection for partial-thickness supraspinatus tendon tears, and to report the rate of surgical avoidance.
Methods: Retrospective analysis of a prospectively maintained single-practice registry (STROBE-compliant). Twenty-four consecutive patients with ultrasound-confirmed partial-thickness supraspinatus tears received a standardized, ultrasound-guided, multitarget autologous BMAC injection (~12 mL, prepared from 120 mL of iliac crest aspirate by two-spin centrifugation). The primary outcome was change in the Single Assessment Numeric Evaluation (SANE) score from baseline to final follow-up; secondary outcomes were the Numeric Pain Score (NPS), ultrasound-assessed tear size (% of tendon thickness), and surgical avoidance rate. The study endpoint was August 1, 2025.
Results: Five of 24 patients (20.8%) progressed to surgery and were analyzed separately. Among the 19 non-surgical patients (mean age 48.9 years; mean follow-up 8.4 ± 0.7 years [range 7.0–9.1]), SANE improved from 48 to 82 (mean +34 points; p < 0.001) and NPS from 4.6 to 2.1 (mean −2.5 points; p < 0.001). Mean tear size decreased from 48.9% to 27.9% of tendon thickness (−21.0 percentage points). Complete structural healing (0% tear) occurred in 31.6% (6/19), and 73.7% demonstrated complete healing or improvement. The overall surgical avoidance rate was 79.2%.
Conclusions: Ultrasound-guided autologous BMAC injection for partial-thickness supraspinatus tears was associated with durable improvements in pain and function, a meaningful rate of complete structural healing, and a high rate of surgical avoidance at long-term follow-up exceeding 8 years. These hypothesis-generating findings warrant investigation in prospective, controlled trials.
Level of Evidence: IV (retrospective case series).

Biologic Orthopedics Journal

DURABLE 8-YEAR CLINICAL AND STRUCTURAL OUTCOMES FOLLOWING ULTRASOUND-GUIDED AUTOLOGOUS BONE MARROW ASPIRATE CONCENTRATE INJECTION FOR PARTIAL-THICKNESS SUPRASPINATUS TEARS