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Your Guide to Non-Surgical Relief for Rotator Cuff Tears
Free Download: Stem Cell Therapy for Rotator Cuff Disease
Disclaimer:
The information provided by R3 Stem Cell is for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Individual results may vary and are not guaranteed. The FDA considers stem cell therapy experimental at this point.
Any claims made on this website refer to procedures performed OUTSIDE of the USA. R3 Stem Cell has clinics in Mexico, Philippines, South Africa, Turkey, India, Pakistan.
Please fill out the form below to receive the guide
Every day, R3 Stem Cell receives inquiries worldwide from individuals asking if stem cell therapy can help with rotator cuff related pain. Spoiler alert: It can help a lot! In this guide, we’ll go through the basics of how stem cells work for rotator cuff disease, the latest research, and what to expect with a regenerative procedure.
Shoulder injury questions? Call us now at (844) GET-STEM.
Shoulder pain has been known as the third most common musculoskeletal pain (16%) next to back (23%) and knee (19%) pain in the general population. However, it is the most common in the age group of the highest productivity, 40-59 years, posing a substantial socioeconomic burden. Rotator cuff disease or tendinopathy is the leading cause of shoulder pain, accounting for up to 70% with more than 4.5 million physician visits and 300,000 repairs per year in just the USA alone.
Traditional Treatments for Rotator Cuff Disease
Initial treatment for patients with rotator cuff disease, even for patients with a full-thickness tear, would be conservative treatments such as rest, physiotherapy, non-steroidal anti-inflammatory drugs, and corticosteroid injection. But, despite generally favorable outcomes after conservative treatments, a considerable number of patients (41%) showed persistent symptoms after 1 year of nonoperative treatments.
Especially, subacromial corticosteroid injection, one of the most heavily used conservative treatments, has been reported to provide only short-term pain relief without modifying the natural course of the disease, or even, it may be worse in the intermediate and long terms. Of further concern, corticosteroid could induce the depletion of tendon stem cells resulting in tendon tear.
Surgery, while generally successful, has some drawbacks, including the potential for complications, a lengthy recovery, and some authors report that it may not be better than conservative management.
Wondering if stem cells could help your rotator cuff tear? Talk to us at (844) GET-STEM.
If a new technology such as mesenchymal stem cell and exosome therapy could provide a long term solution for rotator cuff disease, it would and should become first line therapy. A regenerative therapy that can relieve pain and improve shoulder function that is a safe, nonsurgical option should receive consideration.
Some people ask us if PRP, platelet rich plasma therapy, is sufficient for the treatment of rotator cuff disease. The answer is no! Two recent reports (a meta-analysis and a double-blinded, randomized controlled trial (RCT)) concluded that injection of PRP is NOT beneficial in the nonoperative treatment of rotator cuff disease. Considering the potential mismatch between growth factors released by PRP and an insufficient number of stem cells in partial thickness rotator cuff tears to be stimulated by these growth factors, the application of mesenchymal stem cells PLUS PRP appears to be the better option for treating rotator cuff disease.
In animal models, injections of adult stem cells into pathologic rotator cuff tissues has been shown to produce a number of beneficial effects, including a decreased number of inflammatory cells, improved regeneration of tendons with less scarred healing, improved collagen fiber arrangement, higher load-to-failure, and higher tensile strength of the treated tendons.
Application of MSCs via injection, not surgery, should provide invaluable treatment opportunities to patients
if it could be translated into routine clinical practice as it would avoid surgery and concomitant risks as well expedite recovery.
In a first-in-human clinical trial published in 2018 from Korea, 19 participants received mesenchymal stem cells with intratendinous injections performed under ultrasound guidance.
Over the two year follow up period, injection of MSCs also significantly alleviated shoulder pain with more than 70% reduction from the baseline in the high-dose group that is far beyond the clinically meaningful pain reduction of approximately 30%. MRI examination showed that volume of the bursal-side defect significantly decreased by 90% in the high-dose group.
Arthroscopic examination demonstrated that volume of the articular- and bursal-side defects decreased by 83% in the mid-dose group, and 90% in the high-dose groups, respectively. Taken together, these results suggest that intratendinous injection of mesenchymal stem cells for the treatment of rotator cuff disease is safe, and effective with evidences of regeneration of tendon defect WITHOUT surgery.
In a 2020 study published in the USA, Hurd et al evaluated 20 participants with rotator cuff disease. They were randomized to receive either a cortisone injection or mesenchymal stem cells. The results of this pilot study suggested that the use of mesenchymal stem cells in subjects with partial thickness rotator cuff repair is safe and leads to improved shoulder function without adverse effects.
In a recent USA pilot study from Striano et al, 20 participants received shoulder injections with mesenchymal stem cells. Significant improvement was noted through all time points to one year. Outcomes assessed immediately following treatment, at weeks 1 and 5, months 3, 6 and 12 by Numerical Pain Scale (NPS) and The American Shoulder and Elbow Surgeons Score (ASES). NPS (p<0.00008), ASES (p< 0.00017). The average improvement of NPS was from 7.5 to 3.6 over one year. The average ASES from 33.7 to 69.2 at one year (0-100 scale 100 perfect function). No post procedural complications or serious adverse events were reported.
The results demonstrated significant improvements in pain, function disability and quality of life as represented by positive outcomes in all measured scores through twelve months with no adverse events reported.
In R3’s experience, 90% of patients with rotator cuff disease achieve success with stem cell and exosome therapy. It’s an exciting option for patients!
In R3’s experience, 90% of patients with rotator cuff disease achieve success with stem cell and exosome therapy. It’s an exciting option for patients!
Why doesn’t R3 Stem Cell Use A Person’s Own Stem Cells for rotator cuff disease?
R3 used to perform autologous therapies, where a patient’s own bone marrow or adipose stem cells were used. However, a lot of stem cells in one’s body are as old as that person is, and hence not very active. Their ability to successfully increase sufficient blood flow and allow for shoulder repair is inferior to umbilical cord stem cells.
Specifically, the therapeutic potential of autologous bone marrow or adipose stem cells in the treatment of older patients is impaired by a number of age-related factors such as oxidative stress, telomere length, DNA damage, disease, and long-term use of some medications.
This is in stark contrast to the youthful genotype and phenotype of neonatal tissue-derived stem cells, such as those from the umbilical cord. They are better at facilitating repair and regeneration of tissue damage, creating new blood flow with superior anti-inflammatory and immunomodulatory efficacy compared to mature stem cells from one’s adipose or bone marrow.
As a result of the inferiority of autologous stem cells due to the reasons above and better results being seen with umbilical cord stem cells, R3 only uses the donor stem cells today.
We’ve helped others recover from rotator cuff damage — call (844) GET-STEM to learn how.
Stem cells and exosomes act in the body through several mechanisms. They do NOT become part of a patient’s DNA, which means they do not engraft into the person’s existing cells. The predominant method of action is thought to be through paracrine mechanisms, which means “cell to cell” interaction.
They act through:
Angiogenesis
provokes formation of new blood vessels.
Reduce inflammation
lack of blood flow to the shoulder is associated with significant inflammation, and the regenerative biologics reduce it nicely.
Immune system modulation
the stem cells and exosomes modulate the immune system very differently than steroids. Instead of blankety suppressing the immune system, the regenerative biologics tamp down the harmful processes while amping up the beneficial ones. This includes ramping up production of several helpful growth factors and cytokines, while tamping down harmful ones.
Cellular signaling
the biologics are able to perform "cell-to-cell" communication. This promotes recipient cells to proliferate their growth factor production, protein production and regenerate tissues that are damaged.
Prevent cell death
most cells have a timed death, where they are only allowed to live a certain length of time. This is called apoptosis. The regenerative biologics allow normally functioning cells (i.e. neurons) to live longer, and spare them from the pre-programmed death.
Preventing scar tissue
Rotator cuff disease patients may experience significant scarring throughout the shoulder. Once that scar tissue forms, it becomes nonfunctional. Stem Cells and exosomes are great at preventing scar tissue (anti-fibrosis).
Stem Cells can also release a huge variety of molecules into the extracellular environment. These molecules, which include extracellular vesicles, lipids, free nucleic acids, and soluble proteins, exert crucial roles in repairing damaged tissue.
Along with offering MSCs for treatment of rotator cuff disease, R3 Stem Cell often includes stem cell exosomes, which are a type of extracellular vesicle participating in extensive cell to cell communication for new blood flow creation.
Thinking about non-surgical support for your shoulder? Let’s talk: (844) GET-STEM.
Where do the stem cells and exosomes come from?
R3 Stem Cell’s regenerative biologics originate from umbilical cord tissue that has been donated after a scheduled c-section. No baby (or mother) is harmed during the C-section procedure. The umbilical cord tissue is normally discarded, but if the mother passes screening tests then the umbilical cord is immediately sent to the lab. The screening tests are extremely rigorous, and mandated by the USA FDA.
The lab carefully processes the umbilical cord to generate large amounts of stem cells and exosomes that are of the highest quality possible. The lab team consists of multiple PhD’s working in ISO Certified, cGMP compliant clean rooms to ensure quality assurance that exceeds USA FDA standards. The proprietary production process combines the highest potency, safety and affordability for providers to confidently offer exposure procedures.
Millions of dollars have been invested in the pharmaceutical grade production of the biologics including first rate clean rooms, bioreactors, nano-particle tracking analyzers, cytometers, PCR, tangential flow machines and real time environmental monitoring. The quality assurance testing complies with screening and testing standards consistent with the American Association of Tissue Banks, cGMP standards, FDA regulations and the highest level of any regulatory agency globally.
Is stem cell therapy safe?
After a decade of performing over 24,000 stem cell procedures worldwide, R3 knows that the regenerative procedures are safe. The quality control employed during the stem cell production is second to none, and the side effects R3 sees are usually mild to moderate and temporary.
They may include itching, dizziness, lightheadedness, low grade fever, chills, headache, nausea. These are typically temporary. If a patient has an allergic reaction to the multivitamin or a preservative, all of R3’s Centers have the medications to resolve it quickly.
One of the questions we get asked a lot is, “Will the stem cells get rejected?” The answer is NO.
MSCs do not express major histocompatibility complex (MHC) antigens of the class II subtype and contain low levels of MHC molecules of the class I subtype. MSCs also lack the co-stimulatory molecules essential for immune detection, including CD40, CD80, and CD86.
Therefore, MSCs generally have low immunogenicity and can avoid immune rejection by the recipient, which serves as the foundation for their successful application without needing to match the donor to the recipient. Scientists call this being “immunologically privileged.”
Another question often asked is “Is there a chance of a tumor forming?” Current research has concluded that the answer is NO. The mesenchymal stem cells and exosomes used during treatment have never been shown to have tumor forming potential. In fact, they have been shown to be anti-tumor forming.
Find Out If You’re a Candidate
Protocol
For the past decade, R3 has been successfully treating rotator cuff disease with stem cell and exosome injections. The providers often use ultrasound guidance to ensure the highest accuracy.
Each patient receives a combination of mesenchymal stem cells along with platelet rich plasma therapy. The PRP provides an excellent scaffold for tissue repair, and patients are given a multivitamin IV drip too.
R3’s providers use approximately 25 million stem cells for the procedure. PRP, short for platelet rich plasma therapy, is also included at no additional charge. The procedure takes less than an hour!
Why does R3 Stem Cell use donor tissue for its stem cells?
Although autologous (your own) stem cells provide significant advantages, allogeneic (donor) stem cells have more advantages. First of all, autologous MSCs need a long time to culture and expand, which limits its application in treatment, while allogeneic stem cells can be obtained and expanded more quickly, thus avoiding the delay of time window.
Second, age is a factor that affects the physiological characteristics of MSCs. Studies have shown that stem cells from elderly donors have decreased proliferation and differentiation ability. This means they are less in number and less effective!
Similar to the research mentioned above, R3 Stem Cell's outcomes for rotator cuff disease have been exceptional! The patient satisfaction rate is 85% year over year. Patients typically experience pain reduction along with improved shoulder function. Keep in mind results cannot be guaranteed and will vary between individuals.
It may take a couple months to see all the improvements, as it can take that long to build up new blood flow. It should be noted, again, that stem cell therapy is not a cure, and may need to be repeated every few years or so for continued benefit.
Because stem cell therapy for rotator cuff disease is not a permanent cure, it's important to make it affordable. Repeat therapies can help maintenance and/or achieve additional improvements for musculoskeletal health. So a lot of patients seek additional treatments at R3 Stem Cell every few years.
R3 Stem Cell's fees are less than half what comparable (and reputable) regenerative clinics charge. Be wary of clinics trying to pass off PRP as a stem cell therapy. If they mention only taking your blood for the treatment, it is NOT a stem cell treatment!
Talk to the team at R3 Stem Cell — call (844) GET-STEM.
For the past decade, R3 Stem Cell’s Centers globally have performed over 24,000 regenerative procedures in seven countries. Over a thousand have been for rotator cuff disease. Patient satisfaction across all conditions treated is 85%!
R3 combines safety, effectiveness and affordability for the therapies. Internationally, the Intellicell is used, which is culturing the most active mesenchymal stem cells to create the “smartest” stem cell in the world!
R3 Stem Cell offers free consultations for individuals to discuss whether regenerative therapy is indicated for their rotator cuff disease. Simply call (844) GET-STEM to schedule yours!
This guide’s education does not constitute medical advice. The USA FDA considers stem cell therapy experimental. Any claims made in this Guide refer to procedures performed outside of the USA.
References
David Greene, MD, PhD, MBA, Founder/CEO
R3 Stem Cell offers treatments that bring patients hope and options. Hope that surgery can be avoided, and tissue injury can be repaired with patients being able to get back to desired activities.
Founder and CEO David Greene, MD, PhD, MBA writes extensively on regenerative medicine and gives many seminars worldwide on a regular basis. With over forty Centers of Excellence globally, R3 is at the forefront of regenerative therapies.
R3’s Centers have successfully performed over 25,000 regenerative procedures to date. Call today for your free consultation (844) GET-STEM!
No portion of this Document may be reproduced without the Express Written Consent of R3 Stem Cell.
This guide’s education does not constitute medical advice. The USA FDA considers stem cell therapy experimental. Any claims made in the Guide refer to procedures performed outside the USA.
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The information provided by R3 Stem Cell is not a substitute for professional medical advice, diagnosis, or treatment. Individual results may vary and only your medical professional can explain all the risks and potential benefits of any therapy based on your circumstances. R3 Stem Cell does not recommend or endorse any specific tests, products, procedures, opinions, or other information that may be mentioned on this website. Reliance on any information provided by R3 Stem Cell, its employees, others appearing on this website at the invitation of R3 Stem Cell, or other visitors to the website is solely at your own risk. R3 Stem Cell is not responsible for the outcome of your procedure. The FDA considers stem cell therapy experimental at this point.
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