March 10, 2010 - Tears in the shoulder's rotator cuff, a common injury among senior citizens due to falls, are painful and restricting. Surgery to repair the damage is successful for pain management, but in many patients it does not result in full recovery of function due to poor healing. New research shows an approved therapy for osteoporosis, Forteo (teriparatide), may speed healing and improve patient outcomes.
The preliminary study from Hospital for Special Surgery in New York is being presented at the American Academy of Orthopaedic Surgeons (AAOS) meeting in New Orleans, which runs March 9-13.
"According to a previous study, only 69 percent of rotator cuff repairs were completely healed when evaluated two years after the surgery," said Scott Rodeo, M.D., co-chief of the Sports Medicine and Shoulder Service at Hospital for Special Surgery and senior author on the study.
"Although not all of the patients with failed rotator cuff tendon healing had poor clinical outcomes, we wanted to look for ways to further improve patient outcomes."
The rotator cuff is a set of four smaller muscles in the shoulder that rotate the upper arm. A rotator cuff tear happens when the tendon part of the muscle tears away from the bone of the upper arm. The repair surgery reattaches the tendon to the bone, but the success depends on how well the interface between the tendon and bone heals.
Much of the time scar tissue forms at that interface, which is not as strong as the original tissue and can lead to a failed repair.
"The healing process occurs from both the bone and the tendon, which is made up of collagen," said Carolyn Hettrich, M.D., MPH, fifth year resident in orthopedic surgery at Hospital for Special Surgery and lead author.
"We knew the drug Forteo is osteogenic and can stimulate bone growth, but we found reports in the literature that it is also chondrogenic, so it can promote cartilage formation as well."
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