Rotator Cuff Tears and Stem Cells

Rotator cuff tears are a common problem that I see in my practice.  Patients will come in complaining of pain along the front and side of the shoulder. They are unable to sleep on the affected shoulder and have difficulty raising the shoulder overhead. Xrays will only show bone so we often order an MRI to better visualize the rotator cuff and other soft tissues in the shoulder.  

Small tears can often be treated conservatively with physical therapy, but larger tears that are full thickness require more advanced treatment. Patients often ask about stem cells as an alternative treatment instead of surgery.  There are many different types of stem cells depending where in the body they are harvested:  blood, bone marrow or adipose tissue.  To date the orthopedic literature does not support the use of stem cells versus surgical repair of a full thickness rotator cuff tear.  I wish it was  just as simple as taking some cells and injecting them into the shoulder, but the results are not scientifically documented.  Yes, there may be anectdotal discussions of patients reporting that their rotator cuff is all healed, but the science does not support it.  Also, most insurance companies consider stem cells experimental and will not cover the cost.  

In closing, for my patients with full thickness rotator cuff tears who have pain, weakness and loss of motion I will recommend surgery if they are a candidate. Perhaps in the future there will be orthobiologics to repair rotator cuff tears, but they are not available now. 

Bruce I. Prager, M.D.

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