Orthobiologics may be effective alternative to exercise therapy after rotator cuff tear
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Key takeaways:
- Bone marrow concentrate for treatment of rotator cuff tears improved patient-reported outcomes vs. home exercise therapy.
- MRI results also showed improvements in the orthobiologic group.
Percutaneous orthobiologic treatment may be an effective alternative to home exercise therapy for treatment of rotator cuff tears, according to results published in BMC Musculoskeletal Disorders.
To compare orthobiologic treatment vs. home exercise therapy in patients with supraspinatus tendon tears, Christopher J. Centeno, MD, of Centeno-Schultz Clinic in Colorado, and colleagues randomly assigned 51 patients aged 18 to 65 years to undergo either autologous bone marrow concentrate (BMC) injection (n = 34) or a home exercise therapy program (n =17). The follow-up period was a minimum of 2 years.
At 3 months, patients in the home exercise therapy group had the option to crossover to the BMC group if they were unsatisfied.
Patient-reported outcomes measured included the numeric pain scale (NPS), DASH score and a modified single assessment numeric evaluation (SANE) score at 1 month, 3 months, 6 months, 12 months and 24 months.
In addition, researchers evaluated preoperative and postoperative MRIs using the Snyder classification system for an objective measure of healing.
Overall, Centeno and colleagues found the BMC group had significantly improved NPS, DASH and SANE scores compared with the exercise therapy group at each time interval.
Radiographically, 73% of patients in the BMC group showed improvements in postoperative MRI in severity and/or location of the tear 1 year or more. Centeno and colleagues also noted most patients receiving BMC showed signs of tear improvement, indicated by decreased tear severity and a conversion from a complete tear grade to a partial tear grade.
“This study suggests that non-surgical treatments such as BMC with platelet injection are a viable alternative treatment option for rotator cuff tears,” Centeno and colleagues wrote in the study. “Further randomized trials using BMC injections with larger samples of patients and blinded comparative control groups are needed.”
They added, “Other advances in technology for rotator cuff rehabilitation should also be considered.”
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Centeno CJ, et al. BMC Musculoskel Disord. 2024;doi:10.1186/s12891-024-07519-6.
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