Regenerative medicine in shoulder injuries: Stem cell augmentation and multi-tissue rotator cuff repair

Shoulder injuries, such as rotator cuff tears (RCTs), SLAP lesions, tendinopathy, and dislocations, are prevalent among athletes and often result in prolonged recovery, decreased range of motion, and reduced career longevity. The evolving field of regenerative medicine, stem cell augmentation, and multi-tissue regeneration provides a promising pathway for improved recovery. Previous research has explored links between bone-tendon-muscle unit healing, retear rates, and recent innovations such as mesenchymal stem cells (MSCs), growth factors (GFs), platelet-rich plasma (PRP), and tissue-engineered scaffolds (TES). This paper presents a critical review of literature published from 2019 to 2025, assessing measurable outcomes including tendon healing, structural integrity, biomechanical performance, and retear rates. A total of 37 eligible studies were analysed after applying inclusion criteria that prioritised methodological transparency and clinical relevance. Findings suggest that regenerative augmentation can significantly improve repair outcomes, particularly in severe cases. In cases of severe or chronic injuries, combining traditional surgical techniques with regenerative medicine approaches may improve patient outcomes by enhancing tendon healing and reducing retear rates. However, variability in protocols and underpowered clinical trials limit broad clinical adoption. This review highlights the emerging role of MSCs, PRP, and TES in sports medicine and discusses current limitations and future directions for translational integration.