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A Shoulder Stem Cell Procedure 6 Year Follow-up

POSTED ON IN Latest News Regenexx-SD Shoulder Shoulder and Rotator Cuff Procedure Outcomes BY Chris Centeno

shoulder stem cell procedure

One of the benefits of being the first physician in the U.S. to use stem cell injections to help orthopedic patients is that every once in a while, an old patient will come back. While we track everyone in a registry, it’s not the same as a patient sitting in front of you telling you how the procedure changed his or her life. Adriana is a dentist from California who just returned to get her knees treated after a successful shoulder stem cell procedure for her rotator cuff tear in 2010. Let’s review what happened with that shoulder.

Shoulder Rotator Cuff 101

The shoulder rotator cuff is a collection of muscles that help stabilize the shallow socket of shoulder joint. They can be torn through trauma or sometimes just through degenerative wear and tear. While physical therapy is often recommended for partial tears, patients with a complete tear of one or more of the muscles usually end up in surgery. That procedure focuses on sewing back together the torn parts. However, the results from surgery aren’t fantastic:

In addition, strangely enough, the shoulder rotator cuff surgery results the patient reports don’t have anything to do with whether the shoulder heals on a subsequent MRI, which begs the question, why are we sewing the torn bits together? In addition, the pain the patient feels is much more related to the local levels of nasty inflammatory chemicals than it is to the size of the rotator cuff tear.

Adriana’s Story

Back in late 2010, I evaluated Adriana at our Colorado clinic. She was miserable. She had injured her left shoulder and knew things were bad because the pain was waking her up at night. In addition, at a recent wedding, she wasn’t even able to zip up her own dress. She was a dentist who used that hand all day to hold mirrors and other things, which meant keeping the shoulder in a raised position. Her MRI showed a complete rotator cuff tear, but, thankfully, it wasn’t retracted (meaning it wasn’t pulled back like a snapped rubber band). Most patients with complete tears don’t know which type they have—retracted or not—and this is often not discussed in the radiologist’s report. In November 2010, I injected Adriana’s own stem cells precisely into the rotator cuff tear using imaging guidance in a same-day procedure.

So how did she do? She reports today that after some initial soreness, the shoulder was 100%. She returned to full range of motion without pain and could work all day without discomfort. Zipping dresses? No problem! In fact, this shoulder stem cell procedure lasted for almost six years with just a little bit of return of soreness this past few weeks. Her ultrasound yesterday showed just a small partial-thickness degenerative tear in the infraspinatus. What happened to the full-thickness tear? Not seen on ultrasound yesterday.

The upshot? Since we’ve been injecting stem cells so long, we have the longest experience in how patients fare. So it’s not unusual for us to see patients back 4, 5, 6, or even 10 years later who are still doing quite well. In this case, a very grateful dentist who dodged the surgery bullet with a shoulder stem cell procedure!

 

    *DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.
    Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

    comments

    David Davenport says

    "In addition, the pain the patient feels is much more related to the local levels of nasty inflammatory chemicals than it is to the size of the rotator cuff tear."

    I have a question: does fish oil and other non-NSAID anti-inflammatoriy supplements suppress only the undesirable inflammatory chemicals, or can fish oil interfere with desirable healing inflammation?

    In other words, should patients preparing for stem cell or PRP treatment stop taking fish oil temporarily?

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    Chris Centeno says

    David,

    No, as fish oil promotes healing. Please see: http://www.regenexx.com/new-research-fish-oil-can-turn-bad-inflammation-into-healing/ http://www.regenexx.com/chronic-inflammation-back-pain/ http://www.regenexx.com/chronic-joint-inflammation-stem-cells-arthritis/

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    Michael luna says

    I faxed my M R I results yesterday afternoon and a document from my pcp Doctor can anyone there check to see if you received it and let me know what's next my cell phone # 347-331-1291 Michael Luna thank you

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    Chris Centeno says

    Michael,
    We will check and let you know.

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    Jeannine Frazier says

    This is promising as I just did stem cell treatment on my shoulder on July 12th. Although I had more issues than Adriana, I am hopeful that my shoulder will stop hurting and I can once again take part in life! If anyone out there has had shoulder stem cell therapy, I'd love to hear how you are doing.

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    Chris Centeno says

    Jeannine,

    Wonderful to hear your shoulder has been treated!

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    Waldo says

    Hi, Dr. Centeno, I had shoulder surgery last July of 2015 to re-attach my torn labrum which was (presumably) causing shoulder instability. The surgery did not work and I am still suffering from pain and severe instability. I recently had PRP done by Dr. Brian Shiple here near Philadelphia. Unfortunately, he also used lidocaine and injected it directly into my labrum before the PRP. I can see now why he is a former Regenexx doctor. I also found it very bizarre that his "Center for Sports Medicine" was offering PRP Vampire Facelifts. The PRP didn't work, probably because of the lidocaine; however, during the ultrasound he did tell me that I have a small Hill-Sachs lesion on the head of my humerus and that the back of it is losing cartilage.

    Generally speaking most Hills-Sachs lesions have a corresponding bony Bankart fracture to the glenoid bone. I'm not sure if I have this because I haven't gotten new MRI or CT scans after surgery but I suspect it's very likely. With that in mind, I am considering having a distal tibia allograft Latarjet procedure to add more bone & cartilage to my glenoid and also a micro-fracture plus Biocartilage (which is micronized allograft cartilage mixed with PRP and fibrin) procedure to re-grow the cartilage on my humerus & fix the Hill-Sachs lesion. In addition to all of that, I then want to fly down to the Cayman Islands and have the Regenexx Cultured stem cells injected within 1 week of having my surgery.

    To be sure, I am sick and tired of being in pain and having essentially no function in my right shoulder. At the present moment after months of research, I think this is the best course of action for me to take, what do you think about my plan? Have you had any success treating Hill-Sachs and/or glenoid bone loss injuries with just Regenexx injections alone? (which would mean I could avoid having more surgery)

    Thanks,
    Waldo

    replies

    Chris Centeno says

    Waldo,
    The first and most important issue would be shoulder stability-i.e. how much is there? This is the cause of the bony lesion if it's there-i.e. loose ligaments cause the shoulder to dislocate which knocks off the bone. So focusing on several PRP shots to tighten ligaments is likely the first step. This would need to be done under Ultrasound guidance. I wouldn't be a big fan of your plan since it's maximally invasive and we don't even know the current status of the bone. Is it better to get stem cells to augment the procedure if you need to go this approach? (i.e. less invasive approaches won't work)-Yes. But as discussed, it's kind of like starting with a sledgehammer when a small finish hammer may work well. You can get the job done, but there's a greater likelihood of collateral damage...

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    Barbara Bade says

    I am a new shoulder patient having x-rays 11/14/16 that revealed no cartilage in my left shoulder joint. I refer to this shoulder as my "Post Office shoulder" from a rural country route of 121 miles daily in the past. The surgeon injected steroids that offered no relief and am returning to him 12/05/16 for a follow-up. There is pain 24/7, range of motion is affected as well as sleep and all activities. He says I'm a candidate for a shoulder replacement of which appears to be a mean surgery with a long and painful recovery. Can you help?

    replies

    Chris Centeno says

    Barbara,

    We'd be glad to take a look, as your assessment of shoulder replacement is accurate. The shoulder is an incredibly complicated joint as it has to take the shoulder through the largest range of motion of any joint in the body. Please see: http://www.regenexx.com/shoulder-replacement-recovery-rotator-cuff-damage/

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    Jimmy says

    I most likely have a tear on my labrum. The reason I say most likely is because the 2 occasions that I have seen an orthopedist for it I only had xrays and it was the 2nd time that I was told I had that based on the tests they did on me. I had full range of motion but some weakness and some pains. I did do PT for 4 months and that did help a lot but it was not enough make my shoulder feel normal. I'm thinking of coming in to a clinic to get a prp/stem cell procedure during the summer. I'm aware that this procedure is not covered by insurance. Are the visits leading up to the procedure covered by insurance at all or are they all out of pocket?

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    Regenexx Team says

    Hi Jimmy,
    If you are in network for the Provider you see the extensive exam is usually covered. When you're ready, the way to begin is to click on the "Get Started" tab here: https://www.regenexx.com/conditions-treated/shoulder/, or give us a call at 855 622 7838. Please see: https://www.regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/

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    About the Author

    Chris Centeno

    Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…

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