Shoulder pain that comes from the rotator cuff tear is a common problem. 40% people will experience a rotator cuff tear in their lifetime as much as 70% of shoulder pain issues are related to the rotator cuff.1 Common symptoms are pain with overhead activities or pain with combing hair, brushing teeth or weakness in the shoulder.
Rotator cuff symptoms can usually be treated with physical therapy alone. When that fails, other traditional treatment options such as cortisone shots are used to treat the inflammation which may later lead to tendon atrophy and weakening.
The surgical approach is to amputate a part of the shoulder blade bone to create more space for the rotator cuff to move around in without paying attention to the underlying biomechanical issue. To correct the tear in the rotator cuff the surgeon will hook a suture in the tear to bring the fibers back together again in hopes of this inducing a healing response. However, one reason the rotator cuff is prone to these tears is it has a poor bloody supply to that tendon and a lack of stem cells and platelets available that can heal the tendon. Studies show the failure rate of rotator cuff surgery to be as high as 57%.2
The new leading-edge approach to treating rotator cuff disease involves using ultra-minimally invasive techniques under image-guidance, where a needle can place stem cells very precisely at the location of the tear and bridge the gap between the tear and induce the same healing response. This helps deliver enough blood, nutrients, and cells, for a healing response to occur and the tear to heal itself.
This also cuts down on recovery time from having to perform an invasive surgery. The recovery time from a rotator cuff surgery could mean having your arm in a sling for weeks, where there is very little down time involved following a stem cell procedure and no sling is needed.
The results have been promising. Several studies show benefit of stem cell therapies for rotator cuff disease when compared to traditional treatment options in randomized controlled studies.3,4
Article composed by Dr. Matthew Mcauliffe, fellowship-trained sports and spine medicine physician at SpineNevada.
1. Matsen FA, Titelman RM, Lippit SB, Wirth MA, Rockwood CA. In: Rotator cuff. In The Shoulder. Third Edition. Rockwood C A Jr, Matsen F A III, editors; Wirth M A, Lippitt S B, editors. W B Saunders; Company, Philadelphia, PA: 2004. pp. 695–790.
2. Murrel GC. American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting: Abstract 062. Presented February 7, 2012.
3. Hernigou et al. Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study. Int Orthop. 2014 Sep;38(9):1811-8. doi: 10.1007/s00264-014-2391-1. Epub 2014 Jun 7.
4. Fitzpatrick J, Bulsara M, Zhang M. The Effectiveness of Platelet-Rich Plasma in the Treatment of Tendinopathy A Meta-analysis of Randomized Controlled Clinical Trials. American journal of sports medicine. 2017 (45) no. 1. 226-33.
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