Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.
Treating a rotator cuff tear with stem cell injection rather than surgery can be difficult, especially when you don’t know where the tear is located. Injecting the rotator cuff blind without imaging is a challenge, as it’s a deep muscle and placing a needle into it without the ability to see where the needle is going is like driving your car with mud on the windshield-it’s possible, just not advisable. This video shows us injecting stem cells into the rotator cuff of a physical therapist with a tear in the tendon/muscle. You can see the needle off to the right (diagonal line) and the supraspinatus tendon/muscle right on top of the humerus bone. This is a cross sectional view of the area. In the last part of the clip, you see something spread from the end of the needle. This is a good shot of the stem cells spreading into the damaged tendon. For this patient, a combination of the Regenexx-PL and Regenexx-SCP procedures were used. Again, as I have blogged in the past, part of the Regenexx difference is the ability to place cells where they’re needed with high accuracy. We also have before and after ultrasound images on the same patient that will be posted later this week.
Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.
Interesting study presented at the Orthopedic Research Society on how shoulder range of motion and stability aren’t restored fully by rotator cuff surgery.Shoulder rotator cuff surgical repair has become the standard for patients with rotator cuff tears seen on MRI and who still have pain and lost function. Most patients believe this surgery is allot like taking your car into the mechanic to replace a worn-out part in that after surgery, the shoulder will perform like new. We’ve seen patients for years who often complain of less function after surgery than they had before surgery, so this study is helpful to see why this happens. The researchers looked at the patient’s shoulder that was operated with rotator cuff surgery vs. the opposite shoulder without the surgery. They used sophisticated high speed x-ray to check on how much the shoulder joint moved. The shoulder movement was analyzed at 3, 12, and 24 months after surgery. They concluded that shoulder strength and joint stability as well as range of motion wasn’t restored. What long-term implications might this have? Shoulder stability is crucial to protect the shoulder joint long-term. Lost range of motion also means that other joints will be have to be used more to compensate. The reason? Shoulder rotator cuff repair is a big surgery that can reconnect severed rotator cuff tendons, but often these tendons can’t be repaired to their pre-tear integrity. In addition, recovery times from shoulder rotator cuff surgery can be long, often in a large pillow immobilizer, which can weaken tissues. Also, fatty atrophy of the rotator cuff may set in (the muscles may get smaller and weaker and get replaced by fat tissue) and this atrophy isn’t helped by shoulder rotator cuff repair. Finally, since any surgery will generally have more secondary side effects effects of tissue damage compared to any injection, we recommend to our patients that if they have a partial rotator cuff tear, a full thickness and non-tracted tear (the ends of the tear are still together), or severe tendinosis (the tendon is aggravated and perhaps frayed), that they try stem cell injection therapy before considering surgery.
Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.
Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.
Patients today have many options to treat a shoulder rotator cuff tear and often explore those options through research on the internet before they decide which treatment (surgical, non-surgical stem cell injection, physical therapy) fits the best. A recent study examined what was the optimal time for surgery of a rotator cuff tear. These patients had a painful tear due to trauma, weakness in the shoulder, and couldn’t fully lift the shoulder to the side and over their head. The study concluded that surgical rotator cuff tear outcome wasn’t compromised (regardless of the rotator cuff tear size) up to four months after injury. Most tears could also wait longer, but patients with massive rotator cuff tears who waited longer than 4 months had the worst outcome. As we advise patients on what type of rotator cuff tears we believe we can treat through injection of their own stem cells under imaging guidance and which types would be better treated via surgical repair (usually the massive rotator cuff tears with retraction of the two ends need surgery), it’s helpful to reassure patients that waiting to make a decision about whether surgery or stem cell injection is right, up top a point, doesn’t seem to impact surgical outcome. While many rotator cuff tears can be treated successfully with the injection of the patient’s own stem cells, if that process doesn’t work, at least in tears that aren’t the massive, retracted type (which we wouldn’t generally treat with stem cells), waiting for surgery to try a non-surgical option, doesn’t seem to negatively impact outcome.
Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.
The failure of the cultured stem cells in this animal model may have been due to issues that we’ve observed in other research studies. One thing we’ve noticed is that to get enough cells to create a single treatment, it’s common for researchers to pool the cells of several subjects. In addition, the appearance of the stem cells used in these studies often shows that the cultured cells have been grown for too long a time and are under severe stress (not healthy). This may explain why the cultured cells didn’t work as well as fresh cells from a stem cell concentrate. However, the fact that this study confirms an animal model of tendon healing is consistent with results we’ve observed when we inject the stem cells obtained with the Regenexx-SD and Regenexx-C procedures into tendon tears. In addition, any injection based treatment for tendon tears will be significantly less traumatic and usually have a much shorter recovery time than any open surgical treatment.
Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.
A study out this month shows that rotator cuff tears in the shoulder are common in elderly patients with diabetes. This makes sense, as based on our stem cell culture experience with Regenexx-C, diabetic patients were less likely to have stem cells capable of growing to high numbers in culture. This study showed more shoulder joint effusions (swelling) in diabetics as well as swollen tendons (such as biceps). In addition, diabetics had more tears in the supraspinatus (one of the muscles of the shoulder rotator cuff). The authors discussed that in diabetics, routine shoulder imaging with ultrasound may be a good way to prevent major tears from occurring. This also would be a great application for stem cell therapies like Regenexx-SD or Regenexx-SCP, where injections of these cells could be performed using ultrasound guidance to deliver cells to the exact weak areas and minor tears, hopefully to prevent a full thickness rotator cuff tear from developing (one that might only be successfully treated with higher risk surgery). This approach may make financial sense as well, since shoulder rotator cuff surgery is less successful in diabetics when compared to patients without diabetes. If you add this shoulder treatment approach to the success we’ve already seen in helping patients with rotator cuff tears avoid surgery by injecting their own stem cells, this may be a great way to deploy stem cell therapies for shoulder problems in the future.
Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.
Questions? Call us at 303.495.4014 or Toll Free 1.888.525.3005
Search the Regenexx Site
Webinar with Dr. Christopher Centeno
June 19th at 5:15pm MST. - Using Your Own Stem Cells to Heal Your Body. Free Regenexx Procedure Webinar and Q&A. Register below: June 19th Registration
Orthopedics 2.0 – Free Download
Free E-book: Orthopedics 2.0 - How Regenerative Medicine and Interventional Orthopedics will Change Orthopedics Forever Download Orthopedics 2.0 Here>>
