New Orleans, LA—March 9, 2018
A rotator cuff tear is a common shoulder injury that often necessitates surgical repair. Despite advances in techniques, poor tendon healing after surgery is a common problem. There has been increased interest in cell-based approaches to improve tendon healing, and a number of studies are under way at Hospital for Special Surgery (HSS). In the current pilot study, Scott Rodeo, MD, co-director of the Orthopaedic Soft Tissue Research Program at HSS, and colleagues set out to evaluate the use of bone marrow aspirate concentrate in arthroscopic rotator cuff repair.
Bone marrow aspirate, which is taken from fluid from a patient’s bone marrow, contains stem cells that may help in the healing of some bone and joint conditions. HSS orthopedic surgeons extracted the aspirate from the patient’s hip bone in a minimally invasive procedure at the time of arthroscopic rotator cuff repair.
The researchers evaluated patients one year after surgery and found similar outcomes between those who had received the bone marrow aspirate and those who did not. "Although the concept of improving rotator cuff tendon healing using bone marrow-derived cells is appealing, the preliminary data demonstrate no significant improvement in healing or clinical outcomes at 12 months after surgery," said Dr. Rodeo, who is also co-chief emeritus, Sports Medicine and Shoulder Service at HSS. "This may be due to an inadequate concentration of stem cells delivered to the repair site. There are significant limitations to the use of bone marrow aspirate, including the overall low number of stem cells present in bone marrow and variability among patients. The study points to the need to identify methods to improve the isolation and concentration of bone marrow-derived stem cells."
Dr. Rodeo’s lab continues to analyze study data to correlate the clinical and imaging outcomes with the composition and "biologic activity" of the implanted stem cells. "Further clinical studies are required to evaluate the optimal protocol for use of bone marrow aspirate to augment rotator cuff repair," he said.
About HSS | Hospital for Special Surgery
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the eighth consecutive year) and No. 3 in rheumatology by U.S. News & World Report (2017-2018). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In 2017 HSS provided care to 135,000 patients from 80 countries and performed more than 32,000 surgical procedures. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute was formed in 2015 to realize the potential of new drugs, therapeutics and devices; the global standard total knee replacement was developed at HSS in 1969, and in 2017 HSS made 130 invention submissions (more than 2x the submissions in 2015). The HSS Education Institute provides continuing medical curriculum to more than 15,000 subscribing musculoskeletal healthcare professionals in 110 countries. Through HSS Global, the institution is collaborating with medical centers worldwide to advance the quality and value of care and to make world-class HSS care more accessible to more people.