Overview

The shoulder is a ball and socket joint. The rotator cuff consists of 4 tendons that originate as muscles on the scapula. These tendons attach to the humerus or ball of the shoulder. The rotator cuff is responsible for arm rotation and overhead lifting. Tears tend to be gradual in onset and occur more commonly in those over age 50. The shoulder may be painful with activity and is typically worse at night. Weakness may occur, particularly with lifting away from the body and overhead activity.

Research

Hernigou et al. reported 10 year follow up on 90 patients who underwent surgery to repair the rotator cuff. 45 patients were injected with bone marrow aspirate concentrate(BMAC)at the time of surgery and 45 patients did not receive an injection. Mean age was 61. Patients were matched for age, sex tear size and location and hand dominance. Rotator cuff healing was determined by MRI or CT arthrogram at monthly intervals for the first 2 years and at 10 years. 100% of the shoulders receiving BMAC injection and 67% of the shoulders that did not were healed at 6 months. At ten years, 87% of the BMAC shoulders and 44% of the control shoulders were healed.

Hernigou P, Lachaniette CHF, Delambre J, Zilber S, Deffiet P, Chevallier N, Rouard H. Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscpy improves healing and prevents further tears: a case controlled study. International Orthopaedics (SICOT) Published online June 7, 2014

Gomes et al. performed rotator cuff repair on 14 patients with a mean age of 59 and injected BMAC during the procedure. MRI performed 12 months postoperatively demonstrated intact repair in all 14 patients. At the one year follow­up, pain and function was significantly improved.

Gomes JL, Canquerini da Silva R, Silla LMR, Abreu MR, Pellanda R (2012) Conventional rotator cuff repair complemented by the aid of mononuclear autologous stem cells. Knee Surg Sports Traumatol Arthrosc (20): 373-­377