Can Stem Cells heal a Retracted Rotator Cuff Tear?
POSTED ON 7/21/2011 IN Shoulder BY Christopher Centeno
Can a retracted rotator cuff tear stem cell injection work? While we have treated many partial rotator cuff tears with stem cells, we haven't traditionally treated complete, retracted rotator cuff tears with stem cell injections. This was due to our concerns that the two ends of the tendon or muscle would need to be surgically pulled together before stem cells might effect some healing. A 'retracted" tear of the rotator cuff muscle or tendon is when the two sides of the tear pull back like a rubber band. They are literally "bunched up" on either side of the tear. As a result of our concerns, we've always limited ourselves to treating rotator cuff tears where the two ends of the tear are close together or there are only small tears that need to be filled.
All of that may have changed with patient JS, a very active 54 year old who injured his shoulder rotator cuff while lifting weights. JS had a 1.5 cm retracted tear (not huge, but sizeable) and was adamant about trying stem cell injections. We finally reluctantly agreed due to the fact that the patient was otherwise a perfect candidate (over the top fit and otherwise healthy). However, we used more specialized splinting of the shoulder, in contrast to the no splinting approach we would normally use with a nonretracted tear. The new bracing strategy was designed to overcome the retraction and bring the two ends of the tear closer together. He was then treated with a Regenexx-SD procedure with follow-up Regenexx-SCP procedures, using exact ultrasound guidance to ensure placement of the stem cells into he tear. The result? Much to our surprise, he reported 99% improvement over the three months and a follow-up ultrasound yesterday demonstrated excellent healing with some fill-in of the retracted gap. In particular, the image above shows that the "bunched-up" appearance of the retracted muscle portion has now changed to the appearance of a more normal rotator cuff muscle. In addition, the tear near where the tendon attaches to the bone has also filled-in.
The upshot? We will track this patient further and get additional follow-up MRI imaging, but so far it does appear that a Regenexx-SD procedure with specialized bracing may be capable of filling in retracted rotator cuff tears. This may be an exciting development, allowing some patients who we thought could only be treated surgically to have a non-surgical treatment option.
NOTE: 99% improvement is not typical. Regenexx-SCP and Regenexx-SD are medical procedures and like all medical procedures have a success and failure rate.
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