LAS VEGAS — Use of bone marrow concentrate containing mesenchymal stem cells as an adjunct therapy showed significant improvement in healing outcomes after rotator cuff repair, according to data presented during the American Academy of Orthopaedic Surgeons Annual Meeting.
Researchers compared the outcomes of 45 patients who received concentrated bone marrow-derived mesenchymal stem cells (MSCs) as an adjunct to single-row rotator cuff repair at the time of arthroscopy with those of a control group of 45 patients matched for tear size and tendon rupture location, dominant shoulder, gender and age who did not receive MSCs. MRI postoperatively confirmed rotator cuff healing or retear at 3 months, 6 months, 1 year, 2 years and at the most recent follow-up.
Results showed non-healing or retear diagnosed on ultrasound and confirmed by MRI among 34% of shoulders. Between the tendons that healed and those that showed deficient healing or a frank retear, the researchers found no significant difference in preoperative cuff tear size at the time of screening or during surgery, with an estimated average cuff tear size of 2.3 cm in the healing group and of 2.2 cm in the group without healing.
Ultrasound and MRI showed an enhanced healing rate and improved quality of the repaired surface when bone marrow-derived MSC injection was used as an adjunctive therapy during rotator cuff repair. The researchers observed 100% of repairs with MSC augmentation healed by 6 months vs. 67% of repairs without MSC treatment. Ruptures during the next 10 years were prevented with bone marrow concentrate injection, according to study results. Eighty-seven percent of the patients in the MSC-treated group had intact rotator cuffs at the most recent follow-up of 10 years vs. 44% of the control group.
Since patients with a loss of tendon integrity at any time up to the 10-year follow-up milestone received fewer MSCs compared with patients who had maintained a successful repair during the same interval, the researchers determined the number of transplanted MSCs to be the most relevant to the outcome of the study group. – by Casey Tingle
Hernigou P, et al. Paper #533. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 24-28, 2015; Las Vegas.
Disclosure: The researchers report no relevant financial disclosures.