Will stem cells heal my torn rotator cuff, or do I need surgery to fix?
Q. I am a 45-year-old competitive racquetball player who has had six months of right shoulder pain. The pain is worst on overhead motions while playing. The discomfort also wakes me at night. An MRI scan showed a partial tear of my rotator cuff tendon.
I have tried anti-inflammatory medications, physical therapy, massage therapy and dry needling. Cortisone injections helped for about one month and PRP injections did not help.
The orthopedic surgeon feels surgery to repair the tendon is the only option. I have heard about stem-cell injections and wonder if this can help heal the tendon or should I proceed with surgery?
A: The rotator cuff tendon is formed from four muscles in your shoulder that converge as a tendon, which attaches to the ball part of your shoulder. This allows you to rotate your shoulder and lift your arm overhead.
When the rotator cuff is torn, some patients will experience pain and weakness. Usually when torn, the tendon does not have the ability to heal itself.
There are a variety of stem-cell options available such as your own bone marrow, your own fat cells, amniotic stem cells, and embryonic stem cells. All these stem-cell options are expensive and usually not covered by insurance.
Additionally, studies at this time show that stem cells are not likely to heal the tendon. The stem cells do have some anti-inflammatory benefit for some and this might temporarily help the pain. It appears to me you have exhausted the conservative treatment options and that surgery to fix the rotator cuff tendon is indicated.
The surgery would most likely be a minimally invasive arthroscopic procedure done as an out patient. Physical therapy post-op is crucial but a good result and return to racquetball in about six months is likely.
Dr. Harlan Selesnick is team physician of the Miami Heat and Inter Miami. Send your questions to HarlanS@baptisthealth.net
