Our Summary

This research paper discusses the common issue of rotator cuff tears (RCT) that orthopaedic surgeons often deal with. After surgery to fix these tears, there is a high chance (up to 94%) that the tear can occur again. This is because the area where the tendon and bone connect doesn’t heal well.

To try and improve healing, scientists have developed methods such as using growth factors, stem cell therapies, and special materials. The use of growth factors and stem cell therapies have been studied extensively in moderate to large RCTs. Special materials are used more for large or massive RCTs.

However, most of the research on these new methods has been conducted on animals. To know if these methods are effective and safe for humans, more research is needed. This paper reviews the most recent progress in treating RCT with these new biological methods.

FAQs

  1. What is the recurrence rate of rotator cuff tears after surgical repair?
  2. What new methods are being developed to improve healing after rotator cuff repair?
  3. Has the effectiveness of these new biological methods for treating rotator cuff tears been confirmed in human trials?

Doctor’s Tip

One helpful tip a doctor might tell a patient about rotator cuff repair is to follow a strict rehabilitation program after surgery. This typically includes physical therapy to strengthen the shoulder muscles and improve range of motion. It is important to follow the exercises prescribed by the physical therapist to prevent re-injury and promote optimal healing of the repaired rotator cuff. Consistency and dedication to the rehabilitation program are key to a successful recovery.

Suitable For

Patients who are typically recommended for rotator cuff repair surgery are those who have a significant tear in their rotator cuff that is causing pain, weakness, and limited range of motion in the shoulder. These tears can be the result of trauma, overuse, or degeneration over time. Typically, patients who have tried conservative treatments such as physical therapy and medications without success are considered for surgery.

In particular, patients with moderate to large rotator cuff tears may benefit from the use of growth factors and stem cell therapies to improve healing and reduce the risk of re-tearing. Patients with large or massive tears may benefit from the use of special materials to help support and strengthen the repair.

Overall, patients who are healthy enough to undergo surgery and who have a realistic expectation of the outcomes of the surgery are good candidates for rotator cuff repair. It is important for patients to discuss their options with their orthopaedic surgeon to determine the best treatment plan for their individual situation.

Timeline

Before rotator cuff repair:

  1. Patient experiences pain, weakness, and limited range of motion in the shoulder.
  2. Patient may undergo physical therapy, corticosteroid injections, or other conservative treatments to manage symptoms.
  3. If conservative treatments are ineffective, patient may be recommended for rotator cuff repair surgery.

After rotator cuff repair:

  1. Patient undergoes rotator cuff repair surgery, which involves reattaching the torn tendon to the bone.
  2. Patient goes through a period of postoperative rehabilitation, including physical therapy to regain strength and range of motion in the shoulder.
  3. Patient may experience pain and stiffness in the shoulder in the immediate postoperative period.
  4. Over time, patient gradually improves in shoulder function and pain decreases as the tendon heals.
  5. In some cases, despite surgical repair, there is a risk of retear of the rotator cuff, which may require further treatment or revision surgery.

What to Ask Your Doctor

  1. What is the success rate of rotator cuff repair surgery in general, and what is the likelihood of the tear reoccurring?

  2. Are there any alternative treatment options to surgery for a rotator cuff tear?

  3. What specific type of rotator cuff repair procedure will be performed, and what are the potential risks and complications associated with it?

  4. Will additional treatments such as growth factors, stem cell therapies, or special materials be used during the surgery to improve healing?

  5. What is the expected recovery time and rehabilitation process following rotator cuff repair surgery?

  6. What are the long-term outcomes and prognosis for patients who undergo rotator cuff repair surgery?

  7. Are there any lifestyle changes or precautions that should be taken after the surgery to prevent future rotator cuff injuries?

  8. How often will follow-up appointments be needed to monitor the healing process and address any concerns or complications?

  9. What are the potential costs associated with rotator cuff repair surgery, and will insurance cover the procedure?

  10. Are there any specific exercises or physical therapy recommendations that can help improve strength and flexibility in the shoulder after surgery?

Reference

Authors: Özdemir E, Karaguven D, Turhan E, Huri G. Journal: Med Glas (Zenica). 2021 Feb 1;18(1):186-191. doi: 10.17392/1305-21. PMID: 33269582