The shoulder is a complex joint with dynamically composed muscles, tendons, and ligaments. Shoulder pain from various conditions can be debilitating and affect ability to perform daily activities. The use of stem cells in the regeneration of musculoskeletal tissue is a new innovative treatment. Stem cells are being used for cartilage regeneration, management of shoulder tendinopathies, as well as for treatment of muscle lesions and bone defects.
The shoulders are the most mobile joints in the body. The shoulder joint is composed of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). These bones are anchored by muscles, tendons, and ligaments, which keep them stable and in normal position. A problem with any of these structures can result in shoulder pain. Shoulder conditions treated using stem cell therapy include:
Rotator cuff tears are a common shoulder problem that often require surgical repair. Regardless of surgical technique, the tendon-to-bone healing rate has been unsatisfactory due to the problems in restoring delicate transitional tissue between tendon and bone. MSCs can differentiate into different mesodermal tissues, and they have strong immunoregulatory, anti-inflammatory, and angiogenic potential.
In a study involving 14 patients with complete tears of the rotator cuff, researchers found that use of stem cells from bone marrow were beneficial. The stem cells were used during the trans osseous repair. At 12 months, 12 of the 14 tears had healed based on magnetic resonance imaging results.
The shoulder stem cell injection procedure begins with the doctor taking a bone marrow sample from the back of the hip (iliac crest). After the hip is numbed with a local anesthetic, the procedure needle is guided into the hip using x-ray guidance. The stem cells are aspirated from the marrow. After removing the procedure needle, the site is covered with a bandage.
The bone marrow solution is taken to the laboratory for processing. The solution is spun in a centrifuge machine so the stem cells are isolated from the other blood products. In addition, platelets are concentrated to be injected into the shoulder region as well. The stem cell solution and concentrated platelets are injected into the damaged or injured shoulder component.
After your injection, you are given instructions regarding the post-procedure protocols for the treatment site. For some shoulder conditions, a shoulder brace is given. Two days after the injection, you can remove any bandages from the harvest and treatment sites. You are allowed to shower, but should avoid soaking in a hot tub or sauna for one week. In addition, do not take any anti-inflammatory medications for 3 weeks, including ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), aspirin, and Celebrex.
Shoulder stem cell injections have several benefits. These include:
Mora MV, Iban MAR, Heredia JD, et al. (2015). Stem cell therapy in the management of shoulder rotator cuff disorders. World J Stem Cells, 7(4), 691-699.
