Shoulder Rotator Cuff Surgery Research Review: Does Surgery work Better than No Surgery?

By Chris Centeno, MD /

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You might think that with about 40,000 shoulder rotator cuff tear repair surgeries performed in the United States each year, that there was solid medical evidence supporting that this type of shoulder surgery was effective. However, a recent published review by Agency for Healthcare Research and Quality looked at more than 150 published papers and concluded that there was no solid evidence that rotator cuff surgery benefited patients more than no surgery. Huh? We’re operating on shoulders at a furious pace and we don’t know for sure whether the operations help patients more than not operating? Medicine is like any other field, at some point an idea takes hold and spreads like wildfire. In this case the idea was that sewing the torn shoulder rotator cuff back together was a good idea. It may still be in some patients. However, sewing a shoulder rotator cuff tear means prolonged immobilization as you have to substantially weaken the area through shoulder surgery before you can get it to heal. This type of long-term inactivity for the rotator cuff muscles and tendons can lead to shoulder rotator cuff atrophy and/or a weaker, but healed rotator cuff tendon. Add to that research showing that many patients never regain full range of motion after a shoulder rotator cuff tear surgery, likely due to the same immobilization and prolonged bracing needed to get the shoulder rotator cuff to heal, and it starts to make sense that the research doesn’t support that shoulder surgery is more effective than no shoulder rotator cuff tear surgery. So what to do? Shoulder surgery or no shoulder surgery? We tell our patients that if you have a massive tear and have otherwise good healthy tissue and are an active person who will benefit from working rotator cuff muscles, then surgery may be your best option. However, on the other hand, if you have a partial rotator cuff tear or a full thickness rotator cuff tear without retraction (the two ends pulled apart), then you should consider non-surgical injection based repair rotator cuff strategies rather than shoulder surgery. These injections allow the patient to be more active during recovery and hopefully this increased activity will allow the patient to have a stronger and more functional shoulder rotator cuff repair when compared to a more invasive shoulder surgery.

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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Shoulder

Shoulder

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.

  • Rotator Cuff Tears and Tendinitis
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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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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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  • And more
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Lower Spine

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
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
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Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
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  • Trigger Finger
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  • Other conditions that cause pain
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Elbow

Elbow

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

  • Golfer’s elbow & Tennis elbow
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  • And more
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Hip

Hip

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.

  • Labral Tear
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Foot & Ankle

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.
  • Ankle Arthritis
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