Our Summary

This research paper is about how to treat rotator cuff tears (RCTs), which is a common injury that affects the shoulder. The current treatment methods focus on reducing pain and restoring function, but researchers are now looking into more advanced, targeted treatments. This involves understanding the biological mechanisms of how the injury heals and how the muscles deteriorate after the injury.

The paper discusses the biological processes that occur after an RCT, focusing on how the tendon and bone heal and how the muscles degenerate. They then review current strategies for enhancing the healing process, including stimulating bone marrow, using platelet-rich plasma, and using special types of stem cells.

Lastly, the paper looks at the future of these cell-based treatments. This includes using tiny particles called extracellular vesicles to deliver treatments and stimulating the growth of muscle cells at the injury site.

FAQs

  1. What are the current strategies of care for rotator cuff tear management?
  2. What are some of the current strategies of biologic augmentation for rotator cuff repair?
  3. What might the future hold for cell-based treatments in rotator cuff repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rotator cuff repair is to follow a comprehensive rehabilitation program after surgery to ensure optimal healing and restore strength and function in the shoulder. This may include physical therapy exercises, proper rest, and avoiding activities that could strain the shoulder. It is important to communicate any concerns or pain during the recovery process to your healthcare provider to ensure the best possible outcome.

Suitable For

Patients who are typically recommended rotator cuff repair are those who have severe shoulder pain, weakness, and limited range of motion that is not improving with conservative treatments such as physical therapy, rest, and anti-inflammatory medications. These patients may also have a large or complete tear of the rotator cuff, as well as symptoms such as difficulty lifting the arm, weakness when rotating the arm, or a popping or clicking sensation in the shoulder. Additionally, patients who are younger, active, and have a high functional demand may also benefit from rotator cuff repair to help restore strength and function in the shoulder.

Timeline

Before rotator cuff repair:

  1. Patient experiences shoulder pain and weakness, which may worsen over time.
  2. Patient may undergo imaging tests such as MRI to diagnose the rotator cuff tear.
  3. Patient may undergo non-surgical treatments such as physical therapy, anti-inflammatory medications, and corticosteroid injections to manage symptoms.

After rotator cuff repair:

  1. Patient undergoes rotator cuff repair surgery, which may be done arthroscopically or through open surgery.
  2. Patient undergoes post-operative rehabilitation to regain strength and range of motion in the shoulder.
  3. Patient may experience pain and discomfort in the initial weeks following surgery.
  4. Over time, patient gradually regains shoulder function and strength through physical therapy and exercises.
  5. Patient may continue with long-term rehabilitation to prevent re-injury and maintain shoulder health.

What to Ask Your Doctor

  1. What is the extent of my rotator cuff injury and what are my treatment options?
  2. What is the expected recovery time after rotator cuff repair surgery?
  3. What are the potential risks and complications associated with rotator cuff repair surgery?
  4. Will I need physical therapy after surgery, and if so, for how long?
  5. Are there any non-surgical treatment options that I should consider?
  6. What type of biologic augmentation options are available for rotator cuff repair, and are they recommended for my specific case?
  7. What is the success rate of biologic augmentation in rotator cuff repair?
  8. How long do the effects of biologic augmentation typically last?
  9. Are there any potential side effects or risks associated with biologic augmentation procedures?
  10. What is the cost of biologic augmentation for rotator cuff repair, and will my insurance cover it?

Reference

Authors: Jabara J, Kiani S, Youn A, Feeley B. Journal: J Am Acad Orthop Surg. 2025 May 30;33(13):e731-e736. doi: 10.5435/JAAOS-D-25-00069. PMID: 40456132