Stem Cells vs. PRP for Severe Shoulder Arthritis-Shoulder Replacement Alternatives?
Is Regenexx-SD a viable shoulder replacement alternative for the most severe shoulder arthritis patients? JW is a middle aged chiropractor from back east with a severe shoulder problem. The patient had been told for years that he desperately needed a shoulder replacement surgery if he wanted to continue to work. When his nephew (a local chiropractor) called me and asked me to review his films, I was doubtful that we could help his uncle. On these films, JW had severe shoulder joint arthritis with no cartilage and huge bone spurs. In addition, his rotator cuff muscle was severely degenerated with many tears. Basically, saying his shoulder was a mess was an understatement. He had also already tried and failed cortisone, SynVisc shots, and PRP (platelet rich plasma) injections. It should be noted that he didn’t try these things and they worked for awhile, he tried them and had absolutely zero positive benefit. In addition, even strong pain killers did little to help his severe and constant shoulder pain. Since his nephew is a good friend, we agreed to try a Regenexx-SD procedure. We injected his own stem cells under ultrasound guidance into his rotator cuff muscles as well as into his shoulder joints. Here’s JW’s recent e-mail on his response:
“…it’s been four months since I saw you and my ROM is not significantly better. However, the days that I feel reasonably pain free have increased. It’s now rare that I wish I had some pain meds that would be effective.”
While JW isn’t turning out to be rock star patient, he did have a positive response, his first to any treatment he had tried. We will be moving forward with additional treatments, but I think JW is a good example of what we see clinically in our very severe arthritis patients. Patients like JW (the worst of the worst) can still respond to Regenexx-SD or Regenexx-C, despite having failed multiple other injection treatments like PRP. Some have a complete remission, many will need multiple treatments and get meaningful partial improvement, and some won’t respond. Again, our goal is to set reasonable expectations for patient’s like JW and let them make the choice of whether to proceed.