Orthobiologics

Orthobiologics for the Shoulder.

Regenerative options for shoulder pain, rotator cuff, and tendon problems, explained honestly, including where the evidence is stronger and where it is still emerging.

Download the printable guide (PDF)
By jointKneeHipShoulderElbow
What we treat

Common shoulder problems we consider biologics for

Which biologic, and why

Matching the treatment to the shoulder

PRP is the biologic we use most in the shoulder, usually for rotator cuff and other tendon problems. It has also been studied as an add-on during rotator cuff surgery.

For the joint and bone itself, intra-osseous BMAC, placing the biologic into the bone rather than only the surrounding soft tissue, is an emerging and promising approach, and part of why the outlook for the shoulder is improving.

The honest headline. Honestly, of these joints the shoulder has had the weakest evidence, but that's beginning to change, helped by the growing use of intra-osseous BMAC and by longer follow-up that captures benefit earlier studies measured too soon to see.

New to these treatments? Start with the orthobiologics overview for how PRP, Protein Concentrate, and BMAC actually work.

What the science says

A straight read on the evidence

We'll be straight with you: of these joints, the shoulder has historically had the weakest evidence for biologics. That picture appears to be changing, for two reasons. First, the growing use of intra-osseous BMAC, placing the biologic into the bone rather than only the surrounding soft tissue. Second, longer follow-up. Biologics can take longer to show their full effect, and some earlier studies likely called it a failure too soon by measuring outcomes too early. We'll give you an honest read on where your specific problem stands today.

The strongest overall evidence for orthobiologics remains PRP for knee osteoarthritis, recognized in an April 2026 guidance statement from the American Academy of Physical Medicine & Rehabilitation. Evidence for other joints and products is earlier and still developing, and we'll always tell you where yours falls.

Candidacy & expectations

Who this is, and isn't, for

The honest answer depends on you. Here is the general picture, and we settle it together after we examine you and review your imaging.

Often a reasonable option

  • Mild-to-moderate arthritis or a chronic tendon problem still painful after therapy and simple measures
  • Wanting to calm pain and possibly delay surgery, with realistic expectations
  • Even more advanced arthritis, when the goal is to delay surgery, understanding the odds of success are lower
  • Generally healthy enough to heal well, and able to pause anti-inflammatories around the injection

Probably not the answer

  • An active infection, or certain blood or bone-marrow conditions
  • Expecting a guaranteed cure or an overnight result
  • Unable to follow the pre- and post-injection plan, such as holding NSAIDs and resting

On what to expect around the procedure, see preparing for your procedure and after your procedure.

Wondering if it's right for you?

Let's talk it through, honestly.

We'll evaluate your shoulder and give you a straight recommendation, whatever it is, biologics, something simpler, or surgery when that's genuinely the right call.

This page is for general education and is not medical advice. Orthobiologic treatments are not FDA-approved to cure or reverse any condition, results vary from person to person, and they are not right for everyone. Whether a treatment is appropriate for you is a decision we make together after an evaluation.