The plants are still duplicates of the parent, though, just like a divided rootball. I think of it as taking 50 divisions of a peony that I would've divided into 2 or 3 roots. Most tissue culture plants are sold very small--probably like a 2 year plant from seed, still 2-4 years away from blooming. The root ball will eventually end up just as big and pretty much the same as the original plant.
I read about an experiment on the Southern Peony Blog a few years ago, she took tiny pieces of an Itoh and planted it, some just an eye, and almost all of them grew. Always said I was going to try that, just shave off a bit of root with an eye and plant it near the parent plant to see if it would work for me!