Fatty Atrophy of the Rotator Cuff can’t be Reversed by Successful Shoulder Surgery

by Chris Centeno, MD /

What happens to a rotator cuff tear after a few years? The muscle can begin to suffer from fat atrophy. Fatty atrophy means that the torn rotator cuff muscle shrinks with time and get replaced by fat. This phenomenon is seen in many areas of the body and is either caused by disuse or nerve irritation or both. It means that there’s less muscle, which means the stabilizer of the shoulder (rotator cuff), can’t protect the shoulder joint. Since this weaker muscle is caused by not using the painful shoulder, it would make sense that repairing the rotator cuff tear with shoulder surgery might help the patient get the lost muscle back. According to this study, that assumption would be wrong.They found that this fatty shoulder rotator cuff atrophy couldn’t be reversed by successful arthroscopic repair of the rotator cuff tear. In addition, those patients with more of this atrophy had a higher rate of tear recurrence. This makes sense, as the weakened rotator cuff isn’t able to protect itself or the shoulder joint with activity. Some researchers theorize that this fatty atrophy is caused by lack of blood flow to the area which actually causes shoulder muscle cells to turn into fat (myoblasts into adipocytes). In addition, it’s known that CD34+ stem cells (like those found in Regenexx-SD) can cause new blood vessels to form in muscle. Is it possible that injecting these stem cells into a rotator cuff with poor blood supply might increase the blood supply and prevent fatty atrophy of the rotator cuff? While we haven’t documented that this occurs with the Regenexx-SD procedure,  it may be one reason we see patients reporting good improvement in their symptoms and return to normal activities.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
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Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

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Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

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Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
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Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

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Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

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Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
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