50 years ago, the treatment of choice for the rotator cuff tear was observation and physical therapy. The results were very unsatisfactory to the patient and physician. At the same time, historic attempts at surgical reconstruction were doomed to fail. The same was the case for the osteoarthritic shoulder joint. For both rotator cuff tears and advanced osteoarthritis of the shoulder, the only predictable outcome followed a shoulder fusion. The end result Inherent in surgically eliminating the joint (shoulder fusion) be it for trauma, osteoarthritis, or rotator cuff disease was most unsatisfactory.
With a better understanding of the shoulder, joint anatomy, and pathology over the ensuing years came the shoulder joint replacement and rotator cuff surgical repair. Unfortunately, as in any major surgical procedure, there are no assurances of a satisfactory outcome. The risk of postoperative wound infection is real and the need for immediate or delayed repeat revision surgery is ever-present. Additionally, the anatomic requirements for successful, elective shoulder joint replacement and/or rotator cuff repair are more demanding than those of a hip or knee replacement.
Over the past several weeks, four patients presented for hip or knee care for whom, in the past, I had performed a bone marrow concentrate for a combination of an arthritic shoulder joint accompanied by a rotator cuff tear. While it is possible to develop an arthritic shoulder with an intact rotator cuff or a rotator cuff tear without an arthritic shoulder joint; with advancing age, the two problems usually present together. The treatment algorithm for a new patient presenting with shoulder-related symptoms and limited function starts with the medical history followed by the X-ray. In the acute setting, six weeks of physical therapy and a cortisone injection may prove helpful. After six weeks of symptoms and limited function, the MRI is indicated. Based on the response to initial treatment coupled with the results of imaging, via informed consent, I allow the patient to participate in further treatment decision-making.
If the non-dominant shoulder is the source of impairment, some patients will elect to live with their problem. On the other hand, the four patients to whom I am referring at the beginning of the paragraph, elected to undergo a Bone Marrow Concentrate shoulder intervention thereby allowing me to apply autologous Stem Cells, Growth Factors, Precursor Cells, Platelets, Cytokines, and Extracellular Vesicles into the arthritic shoulder joint and torn rotator cuff. Their results are most satisfactory both to the patient and physician. Reader, please be aware that in all four patients, it took time and ongoing physical therapy but in the long run, my patients are functional, symptom-free, and satisfied.
Whether your problem is joint-related or soft tissue in nature and you would like to postpone, or perhaps avoid surgery; call (847) 390-7666 to schedule a consultation. You may visit my web site at visit my website at www.sheinkopmd.com.