Regenexx™ SD Versus Exercise Therapy for Rotator Cuff Tears

Background: Traumatic full-thickness rotator cuff tears are typically managed surgically, followed by rehabilitation, but the load progression to reach an optimal clinical outcome during postoperative rehabilitation is unknown. Purpose: To evaluate whether there was a superior effect of 12 weeks of progressive active exercise therapy on shoulder function, pain, and quality of life compared with usual care. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients with surgically repaired traumatic full-thickness rotator cuff tears were recruited from 2 orthopaedic departments and randomized to progressive active exercise therapy (PR) or limited passive exercise therapy (UC [usual care]). The primary outcome was the change in the Western Ontario Rotator Cuff Index (WORC) score between groups from before surgery to 12 weeks after surgery. Secondary outcomes included changes in the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire score, pain, range of motion, and strength. Adverse events were registered during the intervention period. Results: A total of 82 patients were randomized to the PR (n = 41) or UC (n = 41) group. All 82 patients (100%) participated in the 12-week assessment and 79 in the 1-year follow-up. At 12 weeks, there was no significant difference between the groups in the change in the WORC score from baseline adjusted for age, sex, and center (physical symptoms: P = .834; sports and recreation: P = .723; work: P = .541; lifestyle: P = .508; emotions: P = .568). Additionally, there was no between-group difference for the secondary outcomes including the WORC score at 1 year and the DASH score, pain, range of motion, and strength at 12 weeks and 1 year. Both groups showed significant improvements over time in all outcomes. In total, there were 13 retears (16%) at 1-year follow-up: 6 in the PR group and 7 in the UC group. Conclusion: PR did not result in superior patient-reported and objective outcomes compared with UC at either short- or long-term follow-up (12 weeks and 1 year). Registration: NCT02969135 ( ClinicalTrials.gov identifier)

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Enhanced function and quality of life following 5 months of exercise therapy for patients with irreparable rotator cuff tears – an intervention study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-016-1116-6 ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 9

Author(s):

Birgitte Hede Christensen ◽

Kathrine Skov Andersen ◽

Sten Rasmussen ◽

Elizabeth Lykholt Andreasen ◽

Lotte Mejlvig Nielsen ◽

...

Keyword(s):

Quality Of Life ◽

Rotator Cuff ◽

Exercise Therapy ◽

Intervention Study ◽

Rotator Cuff Tears

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A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis

Stem Cells International ◽

10.1155/2020/5962354 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Christopher Centeno ◽

Zachary Fausel ◽

Ian Stemper ◽

Ugochi Azuike ◽

Ehren Dodson

Keyword(s):

Bone Marrow ◽

Rotator Cuff ◽

Exercise Therapy ◽

Controlled Trial ◽

Rotator Cuff Tears ◽

Full Thickness ◽

Ultrasound Guided ◽

Percutaneous Injection ◽

Bone Marrow Concentrate ◽

Patient Reported

Injectable regenerative therapies such as bone marrow concentrate (BMC) and platelet-rich plasma (PRP) may represent a safe alternative in the treatment of rotator cuff tears. This is a midterm review of a randomized, crossover trial comparing autologous BMC and platelet product injections versus exercise therapy in the treatment of partial and full-thickness supraspinatus tears. Patients enrolled into the study were between 18 and 65 years of age presenting to an outpatient orthopedic clinic with partial to full thickness, nonretracted supraspinatus tendon tears. Enrolled patients were randomized to either ultrasound-guided autologous BMC with PRP and platelet lysate (PL) percutaneous injection treatment or exercise therapy. Patients could cross over to BMC treatment after at least 3 months of exercise therapy. Patients completed the Disability of the Arm, Shoulder and Hand (DASH) scores as the primary outcome measure. Secondary outcomes included the numeric pain scale (NPS), a modified Single Assessment Numeric Evaluation (SANE), and a blinded MRI review. At this midterm review, results from 25 enrolled patients who have reached at least 12-month follow-up are presented. No serious adverse events were reported. Significant differences were seen in patient reported outcomes for the BMC treatment compared to exercise therapy at 3 and 6 months for pain, and for function and reported improvement (SANE) at 3 months (p<.05). Patients reported a mean 89% improvement at 24 months, with sustained functional gains and pain reduction. MRI review showed a size decrease of most tears post-BMC treatment. These findings suggest that ultrasound-guided BMC and platelet product injections are a safe and useful alternative to conservative exercise therapy of torn, nonretracted supraspinatus tendons. This trial is registered with NCT01788683.

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Minimum 2-Year Clinical Outcomes After Superior Capsule Reconstruction Compared with Reverse Total Shoulder Arthroplasty for the Treatment of Irreparable Posterosuperior Rotator Cuff Tears in Patients Younger Than 70 Years Old

10.1055/s-0040-1717567 ◽

2020 ◽

Author(s):

L Lacheta ◽

M Horan ◽

B Goldenberg ◽

G Dornan ◽

PJ Millett

Keyword(s):

Rotator Cuff ◽

Clinical Outcomes ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Reverse Total Shoulder Arthroplasty ◽

Rotator Cuff Tears ◽

Superior Capsule Reconstruction ◽

Reverse Total Shoulder

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Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

American Journal of Sonography ◽

10.25259/ajs-22-2018 ◽

2018 ◽

Vol 1 ◽

pp. 9

Author(s):

Harshad Arvind Vanjare ◽

Jyoti Panwar

Keyword(s):

Rotator Cuff ◽

Negative Predictive Value ◽

Rotator Cuff Tear ◽

Predictive Value ◽

Rotator Cuff Tears ◽

Mri Findings ◽

Cuff Tear ◽

Experienced Operator ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

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