{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:49:11Z","timestamp":1786549751967,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Shoulder disorders\u2014including rotator cuff disease, glenohumeral osteoarthritis (GH OA), and adhesive capsulitis\u2014are among the most prevalent musculoskeletal conditions and are frequently refractory to conservative management. Platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) have attracted increasing clinical interest as regenerative alternatives to corticosteroid injection, but a comparative appraisal of these two principal biologics across the full spectrum of shoulder pathology is lacking. Materials and Methods: This narrative review is based on structured searches of MEDLINE, Embase, Cochrane CENTRAL, and Scopus for clinical studies (randomized controlled trials [RCTs], comparative studies, and prospective series) and evidence syntheses evaluating PRP or BMAC in shoulder disorders. Studies were synthesized narratively by biologic type and disorder; no formal systematic-review or scoping-review reporting protocol was applied. Current society guidelines and consensus statements were additionally examined to position each biologic, and PRP formulation subgroups (leukocyte-rich versus leukocyte-poor) were considered. Results: PRP has the larger shoulder-specific evidence base, supported by several RCTs and meta-analyses in rotator cuff tendinopathy and in adhesive capsulitis; however, results are heterogeneous, effect sizes are generally modest, and some trials show no advantage over saline or corticosteroid. BMAC shoulder evidence is sparse and is strongest as a biological augment to rotator cuff repair (supported chiefly by a case-controlled study) rather than as a standalone injection; standalone shoulder BMAC RCTs are essentially absent. No published RCT directly compares PRP with BMAC for a shoulder disorder; the only direct randomized head-to-head comparison available is in knee osteoarthritis, where the two were reported to be equivalent at two years. Where PRP formulation was examined, leukocyte-poor preparations were associated with better structural and pain outcomes and leukocyte-rich preparations with functional gains in the surgical setting; current society guidance (e.g., the 2025 American Academy of Orthopaedic Surgeons [AAOS] rotator cuff guideline) does not endorse routine PRP use, and BMAC is not yet incorporated into shoulder guideline recommendations. Conclusions: PRP rests on a larger but still heterogeneous evidence base for shoulder disorders, whereas BMAC is biologically promising but clinically under-evidenced in the shoulder. Neither biologic is established as superior. Standardized, shoulder-specific head-to-head RCTs\u2014incorporating biologic characterization, structural (imaging) outcomes, and longer follow-up\u2014represent the most important research priority in this field.<\/jats:p>","DOI":"10.3390\/medicina62081541","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:51:36Z","timestamp":1786449096000},"page":"1541","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biologic Injection Therapy for Shoulder Disorders: A Narrative Review Comparing Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1965-7315","authenticated-orcid":false,"given":"Chul Hee","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Aerospace Medical Center, Republic of Korea Air Force, Cheongju 28187, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4720-4580","authenticated-orcid":false,"given":"Seok Yeon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Aerospace Medical Center, Republic of Korea Air Force, Cheongju 28187, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-2148","authenticated-orcid":false,"given":"Dong Ha","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Aerospace Medical Center, Republic of Korea Air Force, Cheongju 28187, Republic of Korea"},{"name":"Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jor.2013.01.008","article-title":"Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village","volume":"10","author":"Minagawa","year":"2013","journal-title":"J. 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