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Rotator Cuff Tear Treatment: Comparing Bone Marrow and Platelet Therapies vs. Exercise – Midterm Results from Randomized Trial

Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy - A Midterm Analysis

A rotator cuff injury is a condition that affects the tendons and muscles in the shoulder. A rotator cuff is a group of four muscles and multiple tendons that attach the upper arm bone to the shoulder blade. These rotator cuff muscles and tendons lift the arm up away from the body. A rotator cuff injury can occur suddenly, such as from a fall, or it can develop over time from repetitive motions.

Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy - A Midterm Analysis

Symptoms of a rotator cuff injury include pain and weakness in the shoulder, particularly when lifting the arm up or reaching overhead. The pain may also extend down into the upper arm. The reduced range of motion and loss of strength can significantly reduce quality of life for patients with a rotator cuff injury. For example, patients may have difficulty performing normal activities such as dressing and grooming.

In addition, the pain associated with the injury can make it challenging to sleep, which can further impair quality of life. Patients can seek out treatment for rotator cuff injuries that may include ice, physical therapy, and rest. In some cases, patients may need to seek out surgery to repair the damaged tendons or muscles. Although surgery and conventional treatment are often recommended, these methods may not be effective in treating the injury.

However, there may be an alternative to surgery and conventional treatment: stem cell therapy. Stem cells are a type of powerful cell that has the ability to differentiate into almost any type of cell, including cartilage cells. By injecting stem cells into the shoulder joint, doctors can encourage the regeneration of damaged tissue.

A study, 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, looked into the potential of stem cell therapy for rotator cuff injuries. Bone marrow concentrate contains stem cells that can help encourage healing in the shoulder.


Results of the Study

The goal of the study was to evaluate therapies other than conventional treatments, such as exercise therapy. The study enrolled 25 patients who were randomized to either ultrasound-guided autologous bone marrow concentrate with PRP percutaneous injection treatment or exercise therapy. Fourteen patients received the BMC injections, and 11 patients went through exercise therapy.

Patients who did not receive BMC injections could receive BMC treatment after at least three months of exercise therapy. The researchers used the Hand (DASH) score and Disability of the Arm, and Shoulder as the primary outcome measure. The study also used a blinded MRI review, numeric pain scale (NPS), and a modified Single Assessment Numeric Evaluation (SANE) as a secondary measure for patients. The researchers followed up with the patients for 24 months at the time the study was published.

The results of the study were extremely promising for patients who have not seen results with exercise therapy and do not want to undergo surgery. The patients who received the BMC and PRP treatment did not experience any adverse events from the treatment. This result shows that this type of treatment is safe for rotator cuff patients.

The study compared patient-reported outcomes for the BMC treatment versus exercise therapy, and found that the BMC treatment was superior for pain, function, and reported improvement 3 and 6 months after receiving the treatment. The MCID for DASH requirement was met by 61% of the patients that received BMC after just three months. This percentage increased to 91% after 12 months and further increased to 94% after 24 months.

The study found that an MRI review showed a size decrease of most tears after receiving BMC treatment. There was a 26% decrease in patient tears in 14 out of 15 MRI images that were examined by physicians. No patient underwent rotator cuff surgery during the follow-up period, which further points to the effectiveness of the treatment.

The researchers found that the stem cells were able to regenerate tissue and improve the function of the shoulder. Importantly, the patients who received stem cell therapy were able to avoid surgery. The patients who received stem cell therapy experienced a significant reduction in pain and improvements in function compared to those who did not receive the treatment.

The patients who received stem cell therapy showed improvements in pain and function, and there were no serious adverse effects. These findings suggest that stem cell therapy may be a viable treatment option for rotator cuff injuries. However, more research is needed to confirm these results.

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