Treating Rotator Cuff Tears with Stem Cells, Not Surgery

by Chris Centeno, MD /

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I love treating shoulder rotator cuff tears with precise injections of real stem cells. This patient was a weightlifter with a high-grade tear who wanted to avoid surgery and get back to powerlifting. He just sent us a video of his progress, lifting more weight without surgery than most can ever dream of benching! Let’s take a look.

Understanding Rotator Cuff Tears

The rotator cuff is a collection of muscles and tendons in the shoulder. They provide support to and help stabilize the shoulder joint, and allow for a full range of motion in this complex ball-and-socket joint. This is especially true with lifting motions, which if you watch my video above, you will see demonstrated by my patient who is a weightlifter.

Tears in the rotator cuff can occur by injury, such as overstressing the shoulder, particularly when lifting above the head, or they can start to form in middle age and beyond with normal wear and tear. When an MRI shows a tear in the rotator cuff and there is shoulder pain, physical therapy is often tried first, but if that fails, rotator cuff surgery is often the recommendation. But as you will see in my video above, now that there are interventional orthopedic solutions for a rotator cuff tear, surgery shouldn’t be a given. Let’s first review why surgery is usually not the best idea for rotator cuff tears.

Why Not Surgery for Rotator Cuff Tears?

It seems that our gene expression plays a part in rotator cuff healing, in that fewer of our healing stem cells may be called in to repair the tendon or help heal following rotator cuff surgery. You might think surgery would at least be a good idea for a larger rotator cuff tear; however, the research suggests that 60% of those who undergo rotator cuff surgery for large tears experience a failure of the repair and retear the rotator cuff. If you’ve passed middle age (60 and above), the news isn’t good here either: for one in three who have rotator cuff surgery, the shoulder doesn’t actually heal.

What about the shoulder pain? Does rotator cuff surgery at least address the pain, the reason most patients pull the trigger to have the surgery in the first place? Unfortunately, many rotator cuff surgery patients are still in pain following surgery. Why? Because oftentimes shoulder pain isn’t actually due to the rotator cuff tear itself. This is especially true if the rotator cuff tears occur in middle age or older and are the result of natural wear and tear. How do we know this? Many patients who have rotator cuff tears have no pain, but for those who do, what are some other possibilities that could be causing the shoulder pain if not the tear? Inflammation or how you experience pain may be at play, or a nerve at the spine where the nerve branches into the shoulder can become irritated and present as pain in the shoulder.

So what if the rotator cuff and shoulder pain clearly are due to a traumatic injury? Perhaps the rotator cuff became torn while playing sports or exercising for example. Surgery is OK in this case, right? Not so fast. Surgery has actually been shown to be no better for rotator cuff tears than simply participating in physical therapy. A longer-term study also discovered similar results: five years later, 75% of patients with full-thickness rotator cuff tears who had conservative home-based treatments were still appreciating successful outcomes. In addition to still being in pain, those who have rotator cuff surgery often find that they are unable to use the full range of motion in the shoulder.

One way to opt against surgery is to see an Interventional Orthopedic physician and consider stem cell treatments as the patient in my video above did. Let me explain.

Our Patient: Treating a Rotator Cuff Tear with Stem Cells

Our patient Mark is a 40-year-old weightlifter with a high-grade supraspinatus tendon tear. The supraspinatus tendon is part of the rotator cuff complex in the shoulder. This was a pretty significant tear, which even had a little retraction. Be sure to watch my video above to see the before MRI of his shoulder.

The patient received a precise high-dose bone marrow concentrate (BMC) injection. This is a same-day procedure using the patient’s own stem cells. These were injected into his rotator cuff tear using ultrasound guidance.  Six months later, his after MRI (also seen in the video) showed about 50% improvement in his rotator cuff.

Now, 20 months after the procedure, Mark reports feeling 80% to 90% recovered. The video he shared with us recently (included in the video above) demonstrates the true power in the strength of his repair as he performs a 370-pound (yes, you read that right—370 pounds!) chest press. He does these max lifts a few times a year to check his progress and his new goal for sometime later this year is 400 pounds!  I’d say this is proof positive this patient was able to successfully address his rotator cuff tear without surgery.

What Isn’t a Shoulder Stem Cell Injection

You may have seen what looks like news interviews hawking “young” stem cells from amniotic tissue or umbilical cords, You may have even seen big full-page ads in the newspaper. However, these aren’t real stem cell procedures but dead-tissue injections performed poorly by a nurse in a chiropractor’s office. Meaning, what they offer is nothing like what this patient received. To see what a real bone marrow stem cell procedure using ultrasound guidance looks like, see my video below: 

The upshot? Mark’s lift of 370 pounds is impressive! In the end, that’s something no functional questionnaire could capture. The most important thing here? This patient avoided surgery and went back to weightlifting in a fraction of the time surgery would have required. Despite that, you can bet his rotator cuff repair is robust.

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7 thoughts on “Treating Rotator Cuff Tears with Stem Cells, Not Surgery

  1. Rick Kingham

    Great article Dr C. As of today I am 4 weeks post op and am completely blown away at how good I feel. I wish I could talk to this guy in the video and tell him that the power lifting gig is not a good thing speaking from experience. My PB was 405 back in the day, 550 deadlift and 450 in squat in the firefighter olympics. It was absolutely fun but long term too hard on the body.

    I will call someone in your office for some questions on PT soon. Thanks for doing what you do. Only wish I had known about this earlier,
    Rick

    1. Chris Centeno Post author

      Thanks, Rick for the feedback. Man, 405 bench is way up there!

  2. Shirley Howard

    I watched the article on Rotator Cuff Tear, stem cells no surgery and excited about the fact that surgery will not be as successful as I may think. I am a 68 yrs. African American female. I was involved in a car accident where I ran over black ice on the interstate and my car ran into the guardrail on top of a bridge and pushed my car back onto the highway. This helped in 2012. There were no injuries only my vehicle was totaled. In 2917 had my first MRI and was given a cortisone shot that lasted for about a year. I recently had another injection that lasted less than three months and not only is the right shoulder is having pain but now my left shoulder. My doctor said that I need surgery on both shoulders. I’ve never had an type of surgery in my life and I’m terrified. Just had a MRI on both shoulder this month 01-15-19 and 01-17-19 on the left shoulder. Please help me. I am interested in the stem cell procedure. I reside in Lexington, Kentucky

    1. Regenexx Team

      Hi Shirley,
      Steroid injections actually make the situation worse, as they kill the local stem cells and breakdown cartilage and can damage tendons. Very wise to seek a regenerative solution instead of surgery. Please see: https://regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://regenexx.com/conditions-treated/shoulder/. We have several locations around your area. The first step would be to submit the Candidateform here: http://www.regenexx.com and from there the Patient Liaison team will assist in getting you set up with the best location for you.

  3. janice gregory

    I live in Brisbane ,Australia.just wondering where can I get the stem -cell treatment for my shoulder.62 year old female,had a bad fall in October 2018 resulting in broken radial neck bone,had surgery to reattach tricep tendon to elbow joint,various tendon tears.Yesterday had a cortisone + mandane injection for bursitis in my shoulder.I read about cells dying and thought if the pain comes back I might look at stem cell treatment

    1. Regenexx Team

      Hi Janice,
      We’d recommend Dr. Boundy, our Australia Regenexx Provider: https://regenexxaustralia.com.au/?utm_source=regenexxreferral&utm_medium=webreferral&utm_campaign=regenexxlocations

  4. Scott Guthrie

    I recently got cortisone injections in my shoulders. After the injections I now have alot more pain in my left shoulder, the good one, than before. Mri now shows a dlap tear. I believe the injection gave me the slap tear???

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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