New Research: Failure in 6 out of 10 Surgical Repairs of the Shoulder Rotator Cuff

by Chris Centeno, MD /

shoulder surgery alternative

Last week at the American Academy of Orthopedic Surgeons meeting research was presented which demonstrated that large rotator cuff repairs that were repaired surgically retore at a rate of 57% in a series of 500 patients. The researchers demonstrated that the repairs with the largest tears were more likely to tear again. If the patients made it to 6 months after surgery without a retear, they did better than patients who didn’t have intact cuffs at that point.  Is there a shoulder surgery alternative? We’ve argued for years that for smaller rotator cuff tears that are complete or partial, a injection with stem cells or other biologics may be the way to go, as the data on shoulder rotator cuff tears treated surgically isn’t that convincing. Why do we think these larger tears are retearing? Just sewing back the torn ends does nothing to address why the tear happened in the first place, i.e. the tissue quality was poor. This includes a reduction in the blood vessels that supply nutrition to the area as well as the quality of the raw materials-the collagen and muscle fibers. Based on our experience with many patients with torn rotator cuffs, we would recommend trying to fix torn rotator cuff muscles and tendons with stem cells through a needle where possible. When that’s not possible due to the size of the tear, we’d recommend that surgeons consider using stem cells with surgery to address tissue quality. The upshot? IMHO we need to focus more attention to how to improve the strength of the tissue, as sewing back together “tissue paper” is unlikely to be an effective strategy for patients.

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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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.

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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 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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