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Rotator Cuff Tears

Rotator cuff tears are the most common cause of shoulder pain and can cause symptoms of shoulder weakness, pain when lifting or lowering the shoulder and pain at night.

Tears can happen suddenly after a fall or can occur slowly over time. The incidence of rotator cuff tears increases with age.

  • 25% of individuals over the age of 60 have a full-thickness rotator cuff tear
  • 50% of individuals over 80 have a full-thickness rotator cuff tear


Determining the integrity of the rotator cuff tear is essential in deciding between surgical and non-surgical treatment.

NOT all Rotator Cuff Tears Need Surgery

Your shoulder has 4 rotator cuff tendons. Most tears occur int he supraspinatus tendon, but other tendons can be involved.

The type of tear often dictates the treatments:

  • Partial tears: This type of tear is incomplete, meaning the tendon is damaged but has not been completely torn. These types of tendon tears can be managed with regenerative medicine injections.
  • Full-thickness tears: This type of tear is a larger tear where there is now a hole extending through the tendon. They have traditionally been treated surgically, but new studies have shown healing of full thickness tears with mesenchymal stem cell injections.

What are the symptoms of a rotator cuff injury?

Common symptoms of a rotator cuff tear includes:

  • Pain at rest or at night
  • Difficulty lying on the affected shoulder
  • Pain when lifting or lowering the arm
  • Weakness when lifting or rotating your arm

Pain is typically felt over the outside of the shoulder, but can also occur over the front or back of teh shoulder. Not all tears cause pain, and 20% of cases are asymptomatic meaning they don't cause any symptoms.

How are rotator cuff tears treated?

Conservative treatment is effective in 73–80% of patients. Physical therapy can help compensate for a damaged tendon, and the pain can resolve even if the tear does not close.

However, not all patients respond to conservative management and over time partial tears can progress to full thickness tears.

How do you diagnose a rotator cuff tear?

MRI or ultrasound is often used to diagnose rotator cuff tears. In experience hands and ultrasound has similar accuracy to an MRI.

However, despite imaging partial tears can be missed over 50% of the time on an MRI. It can be challenging clinically to differentiate a biceps tendon tear and a rotator cuff tear, and in some cases we use diagnostic injections to help differentiate the source of pain.

Are there alternatives to rotator cuff surgery?

Surgery should be your last option. There characteristic of the tear can help determine if you are a good candidate for one of these alternative treatments.


Why Boston Sports & Biologic ?

Not all physicians performing ultrasound-guided procedures are adequately trained, and PRP or autologous stem cell injections are an advanced technique. It is important that your physician has training in advanced-imaging placement.

In addition, not all PRP and stem cell injections are the same. At Boston Sports & Biologics we use autologous PRP and mesenchymal stem cell products that are compliant with FDA guidelines for homologous use and use 501k FDA cleared devices to harvest and process your own cells to stimulate your native cells to regenerate.

PRP kits used for cosmetics or aesthetics may not have the adequate does of cells for orthopedic indications. The quality of the PRP and injection technique can impact the changes of success. Learn more about these procedures here.


Alternatives to Rotator Cuff Surgery

Learn more about regenerative injections for rotator cuff tears, including how PRP can help avoid surgery

Bone Marrow Concentrate Injections for Rotator Cuff Tears

Learn about the latest research on BMAC injections and rotator cuff tears. Bone marrow aspirate concentrate, or BMAC, is a safe and reliable source of mesenchymal stem cells (MSCs),

FDA Compliance

Bone marrow aspirate concentrate injections are one of the few forms of stem cell delivery in compliance with the US FDA guidelines.

To see you are a candidate and to schedule a consultation with Dr. Sussman contact Us At:

info@BSBortho.com

P: (781) 591-7855

20 Walnut St. Suite 14

Wellesley MA 02481

References:

Brockmeyer M, Schmitt C, Haupert A, et al. Limited diagnostic accuracy of magnetic resonance imaging and clinical tests for detecting partial-thickness tears of the rotator cuff. Arch Orthop Trauma Surg. 2017 Dec;137(12):1719-1724.

Centeno C, Fausel Z, Stemper I, Azuike U, Dodson E. A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis. Stem Cells Int. 2020 Jan 30;2020:5962354.

Edwards P. Exercise rehabilitation in the non-operative management of rotator cuff tears: a review of the literature. Int J Sports Phys Ther. 2016 Apr; 11(2): 279–301.

Fukuda H. The management of partial-thickness tears of the rotator cuff. The Journal of Bone and Joint Surgery—British Volume. 2003;85(1):3–11.

Matthewson G, Beach CJ, Nelson AA, et al. Partial Thickness Rotator Cuff Tears: Current Concepts. Adv Orthop. 2015 (Epub).

Sher JS, Uribe JW, Posada A, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. The Journal of Bone and Joint Surgery—American Volume. 1995;77(1):10–15.

Yamanaka K., Matsumoto T. The joint side tear of the rotator cuff: a followup study by arthrography. Clinical Orthopaedics and Related Research. 1994;(304):68–73.

Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SAJ. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. Bone Joint Surg Am. 2006 Aug; 88(8):1699-704.

Yamanaka K., Fukuda H. Pathological studies of the supraspinatus tendon with reference to incomplete thickness tear. In: Takagishi N., editor. The Shoulder. Tokyo, Japan: Professional Postgraduate Services; 1987. pp. 220–224.