PRP and Stem Cells for Rotator Cuff TearsJune 22, 2018
In our office we offer regenerative injection therapies that include Platelet Rich Plasma and stem cell therapy. These treatments provide a non-surgical healing options for patients who want to avoid surgery, surgical complications, and the long down time traditional rotator cuff surgery may offer.
In this article we will present research that suggests the benefits of Platelet Rich Plasma and stem cell therapy for rotator cuff tear.
In a 2017 paper, doctors in South Korea publishing in the journal Cell transplantation say that a combination treatment of bone marrow derived stem cells and platelet rich plasma therapy accelerates tendon repair in tendinopathy, including in the rotator cuff, by stimulating tendon derived stem cells to multiply and repair.1
In 2018, the same research team writing now in the Journal of orthopaedic surgery and research further noted that marrow derived stem cells and platelet rich plasma therapy improved pain and shoulder function in patients with partial tear of the rotator cuff tendon.2
Why do patients seek regenerative injections instead of rotator cuff surgery? Failure rates of 13-94% have been reported.
In another recent study, doctors at the University Hospital Bern, Switzerland published their data in the Orthopaedics & Traumatology: Surgery & Research.
Despite advances in surgical reconstruction of chronic rotator cuff tears leading to improved clinical outcomes, failure rates of 13-94% have been reported.
Let us note that this research suggests patients explore stem cell or biological augmentation following the the surgical reconstruction of their rotator cuff tears tears. The suggestion is that stem cells may offer an enhanced and accelerated healing,3 and possibly prevent re-tears
Medical studies have shown that the re-tear rate of a surgically repaired shoulder could be anywhere from 20 – 90% depending on the patient circumstance. Recently Australian researchers, presenting at the American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting (February 2012) reported that the failure rate they measured in 500 patients was 57%.
In the few years since this study, not much has changed.
Doctors in Canada reported that “despite improvements in rotator cuff surgery techniques, re-tear rate remains above 20% and increases with tear severity.”4
University of Parma in Italy reports: Arthroscopic rotator cuff repair has good results for some, not for others. The rate of tendon healing is 80% in small tears with a decrease to 30% in large and massive tears. 5
In a July 2017 study published in the journal Bone and Joint Surgery, the prevalence of rotator cuff tears was found to increase with age, and many patients had to undergo surgical repair. The researchers noted: “Re-tears are not uncommon, with rates ranging between 9% and 36% in recent studies, and are a major concern”.6
PLATELET RICH PLASMA FOR ROTATOR CUFF TEARS
There is an amazing amount of research centered on the use of Platelet Rich Plasma in accelerating the healing of rotator cuff tears.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine: the problem of muscle atrophy with fatty degeneration is often seen in rotator cuff muscles with torn tendons. PRP promotes proliferation of myoblast cells, (cells that make muscles while suppressing fatty degeneration).7
Department of Orthopaedic Surgery, University of Michigan: Current literature has exhibited that PRP injections are relatively safe and can potentially accelerate or augment the soft tissue healing process. in the treatment of rotator cuff tears.8
Combined university research lead by Drexel University College of Medicine: The single injection of PRP resulted in safe, significant, sustained improvement of pain, function, and MRI outcomes in the “difficult to treat” Rotator Cuff Tendinopathy patients.9
In a recent paper in the Sports medicine and arthroscopy review, even after surgical intervention, tendon residual defects or “retears” often develop. Platelet-rich plasma therapy may be able to positively enhance rotator cuff tendon healing.10
What Do We Do at Magaziner Center for Wellness?
At the Magaziner Center for Wellness, we conduct a thorough physical evaluation to determine the nature and extent of an injury. When pain persists past conventional treatments – and provided the patient is otherwise in good health – we use regenerative orthopedic procedures to naturally repair damage and eliminate related pain. Both treatments are natural and non-surgical.
Additionally, we use innovative manual therapies to realign the shoulder joint to help ensure proper shoulder motion, and also pay careful attention to ligament and joint capsule tissue that is often injured at the time of a rotator cuff tear.
Would you like to talk to us about your rotator cuff injury? Contact the Magaziner Center for Wellness
1 Kim SJ, Song DH, Park JW, Park S, Kim SJ. Effect of Bone Marrow Aspirate Concentrate Platelet-Rich Plasma on Tendon Derived Stem Cells and Rotator Cuff Tendon Tear. Cell Transplant. 2017 Jan 20. doi: 10.3727/096368917X694705.
2 Kim SJ, Kim EK, Kim SJ, Song DH. Effects of bone marrow aspirate concentrate and platelet-rich plasma on patients with partial tear of the rotator cuff tendon. Journal of Orthopaedic Surgery and Research. 2018;13:1. doi:10.1186/s13018-017-0693-x.
3 Zumstein MA, Lädermann A, Raniga S, Schär MO. The biology of rotator cuff healing. Orthop Traumatol Surg Res. 2016 Dec 30. pii: S1877-0568(16)30191-8. doi: 10.1016/j.otsr.2016.11.003.
4 Haering D, Blache Y, Raison M, Begon M. Mechanical risk of rotator cuff repair failure during passive movements: A simulation-based study. Clin Biomech (Bristol, Avon). 2015 Dec;30(10):1181-8.
5 Di Benedetto P, Di Benedetto ED, Beltrame A, Gisonni R, Cainero V, Causero A. Arthroscopic rotator cuff repair with or without PRP: our experience. Acta Biomed. 2016 Apr 15;87(1 -S):75-83.
6 Diebold G, Lam 9 9 P, Walton J, Murrell GA. Relationship Between Age and Rotator Cuff Retear: A Study of 1,600 Consecutive Rotator Cuff Repairs. JBJS. 2017 Jul 19;99(14):1198-205.
7 Takase F, Inui A, Mifune Y, Sakata R, Muto T, Harada Y, Ueda Y, Kokubu T, Kurosaka M. The effect of platelet-rich plasma on degeneration change of rotator cuff muscles: In vitro and in vivo evaluations. J Orthop Res. 2016 Sep 29. doi: 10.1002/jor.23451. PubMed PMID: 27684960.
8 Mlynarek RA, Kuhn AW, Bedi A. Platelet-Rich Plasma (PRP) in Orthopedic Sports Medicine. Am J Orthop (Belle Mead NJ). 2016 Jul-Aug;45(5):290-326. PubMed PMID: 7552452.
9 Scarpone M, Rabago D, Snell E, Demeo P, Ruppert K, Pritchard P, Arbogast G, Wilson JJ, Balzano JF. Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study. Glob Adv Health Med. 2013 Mar;2(2):26-31. doi: 10.7453/gahmj.2012.054.
10 Barber FA. Platelet-rich plasma for rotator cuff repair. Sports Med Arthrosc. 2013 Dec;21(4):199-205. doi: 10.1097/JSA.0b013e31828a7c6a.