Shoulder and Rotator Cuff Conditions

Atlanta Stem Cell Therapies

Regenerative treatments for shoulder injuries and rotator cuff repair

According to the American Academy for Orthopedic Surgeons, around 7.5 million people each year in the US visit their doctor for advice and treatment of shoulder problems. More than 4 million of those visits are for rotator cuff problems, with rotator cuff tears often causing long-lasting pain and mobility issues.

Shoulder problems can also include upper arm sprains and strains and are frequently the result of athletic activities involving excessive and repetitive overhead motion. Anyone who regularly engages in swimming, tennis, pitching, or weightlifting, or even everyday activities such washing walls, hanging curtains, and gardening is at risk of shoulder injury.

These injuries can have a significant impact on quality of life, affecting a person’s ability to work, engage in child care and personal care, and enjoy favorite hobbies and activities.

Regenerative treatments aim to promote healing of damaged shoulder tissue to relieve painful symptoms of rotator cuff tears and other injuries. Such treatments can encourage the growth of healthy cartilage, bone, and other tissues in the shoulder joints, relieving stiffness and pain, and improving range of motion in the shoulder joint.

These non-surgical stem cell and blood platelet procedures offer a safe and effective alternative to invasive surgical procedures that may result in scar tissue that actually worsens a shoulder injury. In other cases, regenerative treatments may be used alongside traditional surgical techniques to encourage better healing after surgery and to reduce the formation of fibrous scar tissue.

Some of the most common indications for regenerative treatments for shoulder problems include:

  • Rotator cuff strain
  • Glenoid labrum tear
  • Shoulder instability (subluxation or dislocation)
  • Acromioclavicular (AC) joint injury
  • Frozen shoulder (adhesive capsulitis).

Regenerative, cell-based treatments are at the leading edge of orthopedic medicine to address shoulder injuries and painful shoulder conditions. Injections with platelet rich plasma or bone marrow aspirate work by promoting the body’s natural healing processes, supporting the growth of healthy new joint tissue while relieving symptoms such as shoulder pain, stiffness, and reduced range of motion from rotator cuff tears and other injuries.

Mesenchymal stem cells (MSCs) found in bone marrow stimulate the activity of chondrocytes, specialized cells in the joints that promote cartilage regeneration. As such, MSCs can lead to dramatic increases in proteoglycans and type II collagen in joint tissue, and may also help to repair damaged nerve tissue and tendons.

Use of MSCs alongside collagen scaffolds has also been seen to be safe and effective for rotator cuff repair, with greater benefits than standard surgery using sutures. Specifically, MSCs appear to help facilitate dynamic processes involved in tendon repair, enhancing the tendon’s maximum load over time.

Regenerative therapies based on stem cell injections have a number of benefits for shoulder injuries: they are non-invasive, generally safe and effective; they require very little downtime, allowing busy people to get back to their normal routine more quickly; and they use a patient’s own stem cells to stimulate natural healing processes, meaning that there’s no need to delay treatment while waiting for donor graft material, for example.

Regenerative treatments are also an excellent option for shoulder injuries because they actively work to repair damaged tissue and address the root cause of shoulder pain, instability, and other symptoms. Many other treatments simply mask pain while failing to encourage healing for long-term resolution of the problem.

Non-surgical regenerative treatments are usually performed as outpatient procedures, and can include the use of:

  • Bone marrow concentrate
  • Platelet-rich plasma.

Bone marrow concentrate

Bone marrow aspirate is a fluid drawn from the bone, usually the hip bone, using a needle and syringe. This fluid is a source of mesenchymal stem cells that differentiate into the types of cells that build the tissues of the joints and bones.

The extracted fluid may be injected directly into the damaged shoulder joint, or can be processed using a centrifuge to separate out the stem cells and create bone marrow concentrate (BMC).

Injections with BMC are especially advantageous for younger patients with shoulder problems who are looking for a treatment option to help restore or preserve joint motion, strength, and stability. Older adults can also benefit from BMC injections to counteract the age-related decline in stem cell concentrations in joint tissue.

As such, BMC injections may be helpful in inhibiting degenerative processes in the shoulder, including osteoarthritis, while facilitating a timely recovery from injury or after shoulder surgery.

Bone marrow derived mesenchymal stem cells have also demonstrated potential benefits in autoimmune arthritis, a condition which can affect larger joints such as the shoulders. Rheumatoid arthritis, for example, may be linked to abnormal stem cell behavior, and injections with normal stem cells may help counteract such abnormalities.

BMC injections have also been found to help accelerate healing of the tendon-bone junction, reducing scar tissue formation and encouraging healthy tissue growth to relieve pain and restore range of motion.

Read on for more about bone marrow concentrate.

Platelet rich plasma (PRP)

Platelet rich plasma (PRP) contains a rich cocktail of growth factors that help promote tissue healing and relieve shoulder pain. PRP is created by drawing a patient’s blood and then centrifuging it to separate out plasma and stem cells.

The growth factors in concentrated PRP can override dysfunctional biologic activity that is contributing to degeneration or the shoulder joint and attendant symptoms. PRP also encourages the creation of healthy new joint tissue in the shoulder, including helping to repair damaged tendons by enhancing cell proliferation and differentiation into active tenocytes.

Read on for more about platelet rich plasma.