Rotator Cuff Surgery in Patients over 60: All is not Roses

By Chris Centeno, MD /

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rotator cuff surgery recovery

Do patients over 60 have the same rotator cuff surgery recovery? We often believe that getting surgery is like taking your car into get repaired-all potential upside with no downside. However, many studies have shown significant complication rates for common joint surgeries such as knee replacement and hip replacement. A recent study looked at a very commonly operated group, patients who are over 60 with a shoulder rotator cuff tear.The results? About 8% of patients had a complications, consistent with other studies that show the rate of side effects from shoulder surgery to be a bit less than 1 in 10. What was surprising is that the rate of healing in the rotator cuff tears treated with surgery was only 2 in 3, meaning 1 in 3 didn’t heal despite surgery.  This is an important number as it means a healthy percentage of patients over 60 don’t heal their tear despite shoulder surgery and 6 weeks spent walking around in a shoulder immobilizer. Why wouldn’t all the shoulder rotator cuff tears heal? One of the reasons rotator cuff muscles and or tendons tear in middle aged and elderly patients is because of poor blood supply. So since the surgery does nothing to improve this poor blood supply, many of these rotator cuff tears likely struggle to heal, as a poor blood supply means poor healing. This may be an advantage for newer types of cellular based therapies delivered through a needle versus through surgery, as many of these cell types (platelets for PRP and certain stem cells) are known to work by bringing in new blood supply. The upshot? If you’re over 60, getting your shoulder rotator cuff tear surgically repaired doesn’t guarantee it will heal, in fact many patients don’t experience healing despite the big surgical risks and downtime associated with the procedure.

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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Spine

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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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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