There’s allot of interest lately in shoulder surgery stem cell therapy. Bone marrow stem cells have had a nice run in rotator cuff tear surgery recently. First, European bone marrow concentrate pioneer Phillipe Hernigou releases a large case series on injecting bone marrow stem cells into rotator cuff tears after surgery, demonstrating a halving of the retear rate. Now a new study suggests that beating up the bone at the place where the rotator cuff attaches also enhances repair.
The new study looked at 111 patients with chronic rotator cuff tears who received a new type of arthroscopic rotator cuff surgery called Arthroscopic Surface Holding repair treatment. One group of patients received a Bone Marrow Stimulation technique in which multiple holes are drilled into the bone at the attachment point between the bone and the rotator cuff, in addition to the basic surgery. The other group did not. The two groups were evaluated by MRI for the integrity of the repair and re-tear rates. Results were similar for smaller and medium tears in both the BMS and non BMS groups in terms of the integrity of the repair. However, a very large difference was noted in the integrity of the repair in the large to massive tear category for those patients who received Bone Marrow Stimulation as well. Re-tear rates were again similar for small to medium tears, but for the large to massive tear group who did not receive the additional Bone Marrow Stimulation procedure, re-tears were approximately 7 times that of the patients who did, likely showing the efficacy and value of stem cells for rotator cuff repair.
The upshot? For smaller tears, based on our experience, it would seem overkill to perform any surgery as just precise injection of the stem cells seems to promote enough healing seems to work well. However, for massive rotator cuff tears, placing bone marrow stem cells into teh tear through beating up the bone or injecting it afterward (which seems to make a whole lot more sense for reducing downtime) seems to be a winner!