Treating Rotator Cuff Tears with Stem Cells, Not Surgery
POSTED ON 8/15/2018 IN Shoulder BY Chris Centeno
I love treating shoulder rotator cuff tears with precise injections of real stem cells. This patient was a weightlifter with a high-grade tear who wanted to avoid surgery and get back to powerlifting. He just sent us a video of his progress, lifting more weight without surgery than most can ever dream of benching! Let's take a look.
Understanding Rotator Cuff Tears
The rotator cuff is a collection of muscles and tendons in the shoulder. They provide support to and help stabilize the shoulder joint, and allow for a full range of motion in this complex ball-and-socket joint. This is especially true with lifting motions, which if you watch my video above, you will see demonstrated by my patient who is a weightlifter. Tears in the rotator cuff can occur by injury, such as overstressing the shoulder, particularly when lifting above the head, or they can start to form in middle age and beyond with normal wear and tear. When an MRI shows a tear in the rotator cuff and there is shoulder pain, physical therapy is often tried first, but if that fails, rotator cuff surgery is often the recommendation. But as you will see in my video above, now that there are interventional orthopedic solutions for a rotator cuff tear, surgery shouldn't be a given. Let's first review why surgery is usually not the best idea for rotator cuff tears.
Why Not Surgery for Rotator Cuff Tears?
It seems that our gene expression plays a part in rotator cuff healing, in that fewer of our healing stem cells may be called in to repair the tendon or help heal following rotator cuff surgery. You might think surgery would at least be a good idea for a larger rotator cuff tear; however, the research suggests that 60% of those who undergo rotator cuff surgery for large tears experience a failure of the repair and retear the rotator cuff. If you've passed middle age (60 and above), the news isn't good here either: for one in three who have rotator cuff surgery, the shoulder doesn't actually heal. What about the shoulder pain? Does rotator cuff surgery at least address the pain, the reason most patients pull the trigger to have the surgery in the first place? Unfortunately, many rotator cuff surgery patients are still in pain following surgery. Why? Because oftentimes shoulder pain isn't actually due to the rotator cuff tear itself. This is especially true if the rotator cuff tears occur in middle age or older and are the result of natural wear and tear. How do we know this? Many patients who have rotator cuff tears have no pain, but for those who do, what are some other possibilities that could be causing the shoulder pain if not the tear? Inflammation or how you experience pain may be at play, or a nerve at the spine where the nerve branches into the shoulder can become irritated and present as pain in the shoulder. So what if the rotator cuff and shoulder pain clearly are due to a traumatic injury? Perhaps the rotator cuff became torn while playing sports or exercising for example. Surgery is OK in this case, right? Not so fast. Surgery has actually been shown to be no better for rotator cuff tears than simply participating in physical therapy. A longer-term study also discovered similar results: five years later, 75% of patients with full-thickness rotator cuff tears who had conservative home-based treatments were still appreciating successful outcomes. In addition to still being in pain, those who have rotator cuff surgery often find that they are unable to use the full range of motion in the shoulder. One way to opt against surgery is to see an Interventional Orthopedic physician and consider stem cell treatments as the patient in my video above did. Let me explain.
Our Patient: Treating a Rotator Cuff Tear with Stem Cells
Our patient Mark is a 40-year-old weightlifter with a high-grade supraspinatus tendon tear. The supraspinatus tendon is part of the rotator cuff complex in the shoulder. This was a pretty significant tear, which even had a little retraction. Be sure to watch my video above to see the before MRI of his shoulder. The patient received a precise high-dose bone marrow concentrate (BMC) injection. This is a same-day procedure using the patient's own stem cells. These were injected into his rotator cuff tear using ultrasound guidance. Six months later, his after MRI (also seen in the video) showed about 50% improvement in his rotator cuff. Now, 20 months after the procedure, Mark reports feeling 80% to 90% recovered. The video he shared with us recently (included in the video above) demonstrates the true power in the strength of his repair as he performs a 370-pound (yes, you read that right—370 pounds!) chest press. He does these max lifts a few times a year to check his progress and his new goal for sometime later this year is 400 pounds! I'd say this is proof positive this patient was able to successfully address his rotator cuff tear without surgery.
What Isn't a Shoulder Stem Cell Injection
You may have seen what looks like news interviews hawking "young" stem cells from amniotic tissue or umbilical cords, You may have even seen big full-page ads in the newspaper. However, these aren't real stem cell procedures but dead-tissue injections performed poorly by a nurse in a chiropractor's office. Meaning, what they offer is nothing like what this patient received. To see what a real bone marrow stem cell procedure using ultrasound guidance looks like, see my video below:
The upshot? Mark's lift of 370 pounds is impressive! In the end, that's something no functional questionnaire could capture. The most important thing here? This patient avoided surgery and went back to weightlifting in a fraction of the time surgery would have required. Despite that, you can bet his rotator cuff repair is robust.
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