Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I am a cancer survivor with a question for you. I'm thinking about having a rotator cuff tear repaired and the surgeon suggested using growth factors to speed up recovery time. Will this do anything to speed up cancer cells as well?

Answer:

Tendon healing after rotator cuff repairs is a slow process. After surgery, patients are in a special abduction sling (looks like a square-shaped pillow under the arm). They have to wear this contraption for four to six weeks. Some passive movements are allowed while wearing the brace but not all. It isn't until the patient is weaned off the sling that active motion can begin. Then it takes another four to six weeks before strengthening exercises can begin. The question often comes up (especially in sports athletes): is there any way to speed up recovery time? Surgeons are aware that the retear rate of repaired rotator cuffs is pretty high during those first three months. That's why patients are put in an immobilizer and only allowed to do some passive motion. No tension is allowed on the surgically sutured tendon. Without some outside agent to help accelerate healing, the answer to the question is "no." There is one biologic product called platelet-rich plasma (PRP) that has been used to speed up tendon healing in other areas (e.g., elbows). But there aren't a lot of studies using it for rotator cuff tears. In a recent study, orthopedic surgeons from Seoul, Korea compared two groups of patients with full-thickness rotator cuff tears. One group (19 patients) was treated with platelet-rich plasma (PRP). The second group (23 patients) had the repair surgery without the PRP. Platelet-rich plasma (PRP) is the portion of your blood that contains the clear fluid and extra platelets. The platelets are the part of the red blood that contain growth factors known to accelerate or speed up healing. Studies show that PRP helps many types of tissue regenerate such as bone, ligament, cartilage, muscle, and tendon. Despite their hypothesis that the platelet-rich plasma group would have better results, there were no clear differences in any of the measured outcomes between the two groups. In fact, at the three-month mark, the group without platelet-rich plasma (PRP) had slightly better results. Over time, the differences evened out. Pain relief and improved motion was similar in both groups. The persistent loss of external shoulder rotation was also similar between the two groups. Muscle strength improved equally in both groups. In fact, patients were equally satisfied with results in both groups. And there weren't any harmful effects of using the PRP. But the specific use of this product in patients with a history of cancer has not been explored. It's a very good question to raise in discussing your options with the surgeon. The decision may also be affected by the type and location of your cancer. Chris Hyunchul Jo, MD, et al. Does Platelet-Rich Plasma Accelerate Recovery After Rotator Cuff Repair? In The American Journal of Sports Medicine. October 2011. Vol. 39. Pp. 2082-2090.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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