The rotator cuff is one of the most important musculoskeletal regions because it stabilizes the shoulder joint. The shoulder is prone to injury, which can occur either suddenly or over time. Many people with rotator cuff injuries are restricted from doing activities they used to. The treatments are variable, ranging from conservative pain management to a full-blown reconstruction. There is new evidence that stem cells may be useful in managing rotator cuff injuries.
What is the rotator cuff and how can it be injured?
The rotator cuff is made up of the tendons of 4 muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles insert on the humerus and stabilize shoulder motion. A rotator cuff injury occurs either suddenly or over time. People with injuries describe one- sided shoulder pain that is worse with sleeping on that side or reaching overhead. Their range of motion is limited. In cases with small tears early in the course, people may have no symptoms at all.
What is the typical treatment?
Typically, rotator cuff injuries can be dealt with conservatively or with surgery. Conservative treatment includes physical therapy, pain management, and steroid injections. Surgery can include debridement, arthroscopic repair, or a major reconstruction of the joint. In both cases, there is the risk that the joint will continue to degenerate over time or that the tear will get much larger. Even if patients choose surgery, there are multiple risks. Patients who undergo surgery may experience a repeat tear of the rotator cuff, a new issue with a tendon, or complications of the surgery.
Because all existing treatments have drawbacks, scientists have been looking at new treatment options. In particular, stem cell transplant therapy has seemed promising.
What are stem cells?
Stem cells are cells found naturally in various parts of the body that have the potential to become many different types of cells. For example, stem cells found in the bone marrow could become muscle cells. Stem cells found in umbilical cord tissue may become blood cells. Because stem cells can become many different types of cells, they are particularly useful.
How can they affect rotator cuff injuries?
Stem cells research in rotator cuff therapy is still in the beginning stages, relatively speaking. The major questions scientists are answering is whether the stem cells last at the site of injury and whether they actually help.
There are 3 major types of stem cells that have been studied in the rotator cuff. Bone Marrow Mesenchymal Stem Cells (MSCs) were harvested and studied in rats. The scientists found that the MSCs injected were present at the site of injury and were active. They also found that there was a higher amount of fibrocartilage with better fibrocartilage fibers than the control group. They did not find other differences, but they only looked at the rats for 4 weeks.
Another type of MSC being studied in rotator cuffs is the adipose tissue MSC. This is found in fat cells. They can turn into other fat cells, bone, cartilage, and muscle. A group that studied the supraspinatus in rabbits found that these MSCs helped repair the muscle.
Muscle-derived stem cells have also been studied in the rotator cuff. When injected into the supraspinatus tendon, they were found to have generated tissue consistent with normal tendon fibers. Other scientists have found that harvesting stem cells from the rotator cuff itself may actually yield better results. This research is promising, and scientists hope to study more.
What are the next developments in research?
Scientists are actively researching the phases of healing in rotator cuffs so that they may better target the right molecules. They are also actively researching different combinations of stem cells with different molecules. For example, they have found that certain types of MSCs have anti-inflammatory properties and anti-apoptotic effects, meaning they stop desirable cells from dying. They are also researching umbilical tissue stem cells. Preliminary research suggests that those types of cells may particularly help tendon and ligament repair.
How do I learn more?
Stem cell therapy has been found to be beneficial to patients suffering from rotator cuff injuries. At the Stem Cell Transplant Institute, we believe in delivering care according to the latest scientific research findings. If you would like to learn more about how stem cell therapy can help you reach your goals, contact us today.