Let’s start with the real goal: getting back to your life. Maybe that’s lifting your kids, playing golf, or just putting on a shirt without that sharp pain. When you’re told you need a shoulder replacement, it can feel like your only option. But surgery often means a long, difficult recovery and potential long-term weakness. What if there was another way? Finding a real alternative to shoulder surgery is about healing the source of the problem. This is where regenerative medicine comes in, offering powerful alternatives to shoulder replacement that help your body rebuild from the inside out.

Replace the ball and socket of the shoulder joint. The reason a shoulder replacement can be tricky is that the joint is more a golf ball and tee than a ball and a socket like the hip. This, as we will see from the research, can make shoulder replacement a technically challenging surgery.

Manage the shoulder with “conservative non-surgical treatments,” such as painkillers, anti-inflammatories, cortisone, physical therapy, and other remedies for as long as you can until the pain or loss of function becomes unbearable.

Try regenerative medicine such as stem cell therapy and platelet rich plasma therapy.

When someone comes into our institute it is usually after the “conservative treatments,” have failed and that a surgery is being strongly recommended. What people, perhaps one day like yourself, who come into our office want is a realistic plan to get them to a pain-free range of motion in a functioning shoulder. Many times we can get people to this goal, many times we come close to getting people to this goal with significant improvement to their quality of life. There are times when we can only help a little. There are times we cannot help at all. People we cannot help would be significantly advanced cases of degenerative shoulder disease. Perhaps 10 to 20% of patients who seek regenerative medicine will not be good candidates. This is why I invite people to email me to discuss before they make an appointment. You can do so as well by using the form below.

Will I Need More Than One Shoulder Surgery?

We do a lot of research in our clinic, one topic we research often is shoulder osteoarthritis. There are many new studies on the problems of shoulder replacement and fixing a failed replacement.

Here is a 2018 study from a Swedish research team. It appears in the journal Acta orthopaedica (1) and discusses shoulder hemiarthroplasty. Shoulder hemiarthroplasty is a procedure where the ball of the shoulder is replaced with a prosthetic, while the socket (or tee) remains intact.

The two types of Shoulder hemiarthroplasty are:

  • shoulder resurfacing hemiarthroplasty (a protective metal cap is placed over the ball of the humerus head)
  • shoulder stemmed hemiarthroplasty (imagine a thumb tack, the metal cap is attached to a metal stem which is pushed into the humerus head)

Shoulder hemiarthroplasty comes with a high risk of need for second surgery. To quote the research: “. . . while patients receiving resurfacing hemi and stemmed hemi, reported similar shoulder functionality and quality of life, the revision rate for resurfacing hemi (12%) . . . stemmed hemi (6.7%).

The purpose of this study was to find why there was such a difference.: The results were:

  • The younger patients were more likely to receive the resurfacing shoulder hemiarthroplasty and since younger people live longer, the chances of need or more revision surgery is greater. So a skewed result is achieved resurfacing shoulder hemiarthroplasty have a higher risk for revision because the patients were young enough to have multiple surgeries.
  • The older you were, the more likely you would get the shoulder stemmed hemiarthroplasty because you suffered from primary osteoarthritis. Then you had a 6.7% chance of going back to surgery. Since the patients were older, as we have seen in other studies, they would be less likely to want to undergo a second or revision surgery. Older adults fearful of revision surgery also can skew results.

Why Does My Shoulder Still Hurt After a ‘Successful’ Surgery?

In the Journal of shoulder and elbow surgery, researchers tried to gauge what constituted the minimum results necessary to call a shoulder replacement surgery a success. In 326 patients who had either a total shoulder replacement, a primary reverse shoulder replacement, or hemiarthroplasty, in averaging out the patient response outcomes, the researchers found that patients treated with a shoulder arthroplasty require a 1.4-point improvement in the visual analogue pain score (2) (a scoring system of 0- no pain and 10 extreme pain), most of you reading this article will be very aware of this pain scoring system and how it works.

  • If you went to surgery with, for an example 8.4 VAS score or very severe pain, you qualified for a minimal clinically important difference (success) if you reported that pain down to a 7.0. The successful surgery still left you in severe pain. Any pain relief is welcome, but how many peopel would have the surgery for a 10% improvement?

How Strong Will My Shoulder Be After Replacement?

Beyond pain, there is the question of function, strength and durability of the replaced shoulder. There is a lot of research focusing on a patient’s ability to resume normal activity or return to their favorite sport after shoulder replacement. Many studies suggest a great deal of success in the shoulder replacement. Other studies are less favorable.

A study from November 2019 (3) compared the isometric strength and endurance of shoulder abduction and internal and external rotation between operated shoulders and non-operated shoulders in the same patient. The patient underwent reverse shoulder replacement due to degenerative rotator cuff tear.

Who was in this study?

  • 41 consecutive patients (average age of about 71 years old; 36 females vs 5 males) who underwent reverse shoulder replacement. All 41 patients had no symptoms in the other shoulder and normal shoulder function.
  • The average length of follow-up was 34 months.

Results

  • Patients exhibited improvement in functional level in the replacement shoulder.
  • The limitations however following surgery were In the strength and endurance of internal and external rotation which were lower in operated shoulders than the patient’s other shoulder. The durability of internal and external rotation were significantly lower in operated shoulders.
  • While some patients saw improvement in function, surgeon (and patient) should be aware that durability and strength of rotation would be weak.

Outcomes of Reverse Shoulder Replacement

A reverse shoulder replacement can be a necessary step for people with severe rotator cuff damage, often leading to better overall function. But it’s important to have a clear picture of what life looks like after the surgery, especially concerning strength and long-term durability. Research helps paint this picture. For instance, a study in the Journal of Shoulder and Elbow Surgery looked at patients with an average age of 71 who had undergone the procedure. The researchers compared the operated shoulder to the patient’s healthy, non-operated shoulder to see how it measured up in terms of real-world strength and endurance.

The results showed a significant trade-off. While the patients did gain better function, the operated shoulder was much weaker in its ability to rotate inward and outward. The durability of these rotational movements was also significantly lower compared to their healthy shoulder. The study’s conclusion is a crucial piece of advice for anyone considering this path: both surgeons and patients should be aware that while function may improve, the strength and durability of rotation will likely remain weak. This is a key factor to weigh when you explore your treatment options and set realistic goals for your recovery and future activity levels.

Can I Return to Sports and Activities After Surgery?

From July 2019 and the journal Shoulder & Elbow.(4)

  • “Reverse total shoulder arthroplasty is now the most frequently performed form of shoulder replacement. There is currently no consensus on recommended levels of activity and sport following Reverse total shoulder arthroplasty.”
  • “Return to sport is tolerated following Reverse total shoulder arthroplasty; however, studies are short to medium term only and although the reported complication rate is low, the studies did not include radiographic evaluation. Longer term studies with subgroup analysis evaluating common recreational activities after Reverse total shoulder arthroplasty are required, particularly in the younger population, in order to establish clear post-operative guidelines.

What Increases the Risk of a Failed Shoulder Replacement?

The above statement is not an opinion, it is in the research:

  • In a paper published in the March 2017 issue of the Journal of Shoulder and Elbow Surgery, doctors in Germany evaluated and identified risk factors for the development of intraoperative and postoperative surgical complications in total shoulder arthroplasty in patients with primary osteoarthritis.Twenty-seven complications (9.8%) in 275 shoulder arthroplasties were recorded. Mostly from patients who practiced poor lifestyle choices.(5)
  • Also appearing in the Journal of Shoulder and Elbow Surgery, February 2017 issue, doctors at the Steadman Hawkins Clinic of the Carolinas wrote that patients’ resilience, that is the ability to bounce back or recover from stress, an increasingly recognized psychometric property, would do better than patients who do not do well with stress. The patients with low resilience would suffer from greater shoulder complications.(6)
  • Doctors at the University Medical Center of Cologne in Germany also published new research in which a bad problem is can be made much worse by shoulder replacement. The German doctors suggest that a preoperative evaluation of humeral head subluxation (the head of the shoulder is not where it is supposed to be) and glenoid erosion (the shoulder labrum has deteriorated), two factors associated with less favorable postoperative shoulder replacement results, should be considered before moving forward to surgery.(7)

These are just a few of the new studies which if you read them as a whole tells us that patients with poor lifestyle choices, those who do not bounce back well from adversity, those whose shoulders have significant degeneration of the soft tissue, should be offered an alternative to shoulder replacement.

Here is a report from doctors at the Mayo Clinic. It was published in the Journal of shoulder and elbow surgery (8) December 18, 2017 edition. Here are the highlights:

  • 42 patients who had shoulder replacement, two patients had both shoulders replaced. Minimum 10 year follow up. Goal: Long-term assessment of shoulder replacement
  • Studies have demonstrated mixed results after humeral head replacement for osteoarthritis at short- and medium-term follow-up intervals.
  • Some patients experienced significant pain relief postoperatively that was maintained during the long-term follow-up
  • 11 patients more than 25% of the study group reported persistent moderate or severe pain minimum ten years out
  • Ten of 44 (22.7%) shoulders underwent revision surgery, predominantly for glenoid arthrosis (arthritis) (n = 9).
  • In the 25 shoulders with 5 years of radiographic follow-up, patients demonstrated moderate to severe glenoid erosion in 50% at 5 years, which increased to 59% at 15 years and 88% at 30 Years.

Humeral head replacement remains a successful operation for osteoarthritis at long-term follow-up. However, there is a substantive subgroup with continuing pain and a high rate of glenoid bone erosion after 10 years. Surgeons should carefully consider patients’ needs and desires when judging the indications for humeral head replacement.

Why Are Shoulder Replacements on the Rise?

The above study shows the concern for the high number of complications measured long-term in shoulder replacement patients. In a study published in the journal Radiographics, radiologists (9) looked for key imaging features in patient shoulders to help them distinguish between the shoulder problems listed above. If they could find MRI evidence for the source of pain, radiologists could guide surgeons in choosing the type of replacement surgery the patients should get. This they suggested would help limit surgical failures and get the shoulder to as normal a range of motion as possible.

Sounds good, but as we have seen in patients here in our clinic that had an MRI, had the source of their pain pinpointed, had  preoperative planning, had the best prosthetic device for them, had the best intention of the health providers to get that shoulder to as good as new as possible. The surgery still failed catastrophically.

The Prevalence of Rotator cuff Tears

One of the main reasons people develop shoulder pain that leads them to consider surgery is a rotator cuff tear. These tears are incredibly common, and the likelihood of having one increases as we age. In fact, research shows that more than half of people will have some type of rotator cuff tear by the time they reach 80. Many individuals aren’t even aware they have a tear until pain and functional limitations begin to interfere with daily life, making simple tasks like reaching overhead or getting dressed a painful ordeal. Since the rotator cuff is made of tendons and muscles, damage to this soft tissue is often what drives persistent pain. This is why many of our patients are interested in regenerative treatments that work with the body’s own healing mechanisms. For instance, Platelet-Rich Plasma (PRP) therapy uses a concentration of your own platelets to target the injured area, offering a non-surgical approach to managing rotator cuff-related pain and dysfunction.

Can the Surgery Itself Cause More Shoulder Instability?Journal of Elbow and Shoulder Surgery, doctors put a great degree of surgical failure on the shoulder instability the surgery itself caused.

Here is the researchers report:

  • 27 patient case studies were reviewed. These patients had experienced shoulder replacement postoperative instability
  • The type of surgeries were 8 hemiarthroplasties (ball replacement and structural fix of the bone),
  • 14  total shoulder replacements with metal-backed glenoid components, and
  • 5  total shoulder replacements with cemented glenoid components.

The patients had:

  • 10 isolated subscapularis tears,
  • 6 massive rotator cuff tears,
  • 8 component malpositions,
  • 2 component dissociations or loosening, and
  • 1 humeral shortening. (10)

Understanding Shoulder Replacement Surgery

All of these issues—instability, component failure, and persistent pain—highlight that shoulder replacement is a complex procedure. It’s not a one-size-fits-all solution, and the type of surgery recommended often depends on the specific state of your shoulder, especially the health of your rotator cuff. Understanding the different surgical approaches is key to grasping why one might be chosen over another and what the potential outcomes could be. There are two primary types of shoulder replacement surgery that surgeons consider: anatomic total shoulder replacement and reverse total shoulder replacement. Each is designed for a different clinical scenario, primarily distinguished by the condition of the rotator cuff muscles that are so crucial for shoulder function and stability.

Anatomic Total Shoulder Replacement

Think of this as the traditional approach to shoulder replacement. Anatomic total shoulder replacement is typically the go-to option for individuals who have significant shoulder arthritis but still have a healthy, functioning rotator cuff. The goal of this surgery is to replicate the natural anatomy of your shoulder by replacing the damaged “ball” (humeral head) and “socket” (glenoid) with prosthetic components. Because it relies on your existing rotator cuff muscles to power and stabilize the joint, the integrity of these tissues is non-negotiable. The recovery process can be lengthy, often taking anywhere from three to twelve months to regain strength and function, as the body needs time to heal around the new joint.

Reverse Total Shoulder Replacement

Now, what happens if you have severe arthritis *and* a badly torn or non-functional rotator cuff? This is where reverse total shoulder replacement comes in. This innovative procedure is a game-changer for patients who wouldn’t be candidates for the anatomic version. As the name suggests, the surgery “reverses” the mechanics of the shoulder. A prosthetic socket is placed where the natural ball was, and a metal ball is fixed to the shoulder blade. This clever design allows the powerful deltoid muscle, rather than the damaged rotator cuff, to lift and move the arm. While patients may not regain a full overhead range of motion, the recovery can be a bit faster, and it provides a stable, functional shoulder for those with otherwise limited options.

When Is Shoulder Replacement Surgery the Right Choice?

Deciding to undergo shoulder replacement surgery is a major step, and it’s typically considered only after other, more conservative options have been exhausted. If treatments like physical therapy, anti-inflammatory medications, and injections have failed to provide lasting pain relief and restore function, your doctor might bring up surgery as the next logical step. This is often the case for individuals dealing with advanced osteoarthritis that has worn away the cartilage, a significant rotator cuff tear that can’t be repaired, or severe shoulder instability that compromises daily activities. Ultimately, surgery may be presented as the most effective path forward when the structural damage is too extensive for the shoulder to heal on its own.

Making this decision requires a very careful and thorough evaluation by an orthopedic specialist. They will assess your imaging, your functional limitations, and your overall health to determine if you are a good candidate and which type of surgery would be most appropriate. It’s at this critical juncture that many people seek to understand all their options, including non-surgical alternatives. Exploring treatments like PRP Therapy or Stem Cell Therapy can be a crucial step for those looking to avoid or postpone a major surgery. A comprehensive consultation can help you understand if regenerative medicine offers a viable path for your specific condition before you commit to a surgical procedure.

The Best Way to Prevent Surgical Failure

In the Mayo clinic study above, bone disintegration was a great concern. In a recent study, also in the Journal of shoulder and elbow surgery, doctors discuss hardware failures known to plague patients: “The longevity of total shoulder replacement is primarily limited by the performance of the ultra high-molecular-weight polyethylene glenoid component. [This study] demonstrates that glenoid component fracture associated with oxidation has not been eliminated with the advent of modern materials (HXL) in the shoulder domain.”

In other words, the hardware caused an oxidation problem which disintegrated the bone.(11)

The health of bone is obviously very important in shoulder replacement. As you can imagine a revision surgery to fix the problems created by bone disintegration caused by the first replacement will be a complex one.

The following research also from the Journal of Shoulder and Elbow Surgery explains why patients must be given information on treatment options outside of surgery:

  • “The management of a failed shoulder represents a complex and difficult problem for the treating surgeon, with potential difficulties and complications that are related to the need to remove a well-fixed stem.”(12)

If the prosthesis is removed due to failure, the bone becomes compromised, and it is even more difficult to place another prosthesis.

Finding an Effective Alternative to Shoulder Surgery

The problem with shoulder replacement failures are leading researchers to look at shoulder replacement alternatives. One study found that surgical repairs of degenerate and torn tissue are often prone to failure, and that some biological (biomedical) therapies (such as Platelet-Rich Plasma Therapy or Stem Cell Therapy) might improve outcomes. In fact, injections of platelet-rich plasma have led to reduced pain and improved recovery in other degenerated areas, together with the restoration of function.

 

Doctors in Germany looked at repairing cartilage defects and soft tissue injury in the shoulder before it leads to advanced osteoarthritis. They concluded that Stem Cell Therapy for cartilage regeneration was a minimally invasive approach for shoulder joint preservation and an alternative to shoulder replacement.(11)

In the video below, I demonstrate of technique for giving PRP Injections into the shoulder

  • Notice that multiple areas if the shoulder are treated in this treatment
  • The procedure is well tolerated by this patient.

Lifestyle Adjustments and Conservative Care

Before considering an invasive procedure like a total shoulder replacement, it’s worth exploring the full spectrum of conservative treatments. These methods focus on reducing pain, improving function, and slowing joint damage without surgery. For many, a combination of lifestyle changes and targeted therapies can provide significant relief and delay or even eliminate the need for a replacement. These approaches empower you to take an active role in managing your shoulder health. While these methods are foundational, if pain persists, many people explore treatments like PRP Therapy to support the body’s natural healing process before considering more invasive options.

Activity Modification and Ergonomics

One of the most direct ways to manage shoulder pain is to adjust your daily habits. This starts with identifying and avoiding activities that consistently aggravate your shoulder, whether it’s a specific exercise, a repetitive motion at work, or a household chore. Beyond just avoidance, you can also incorporate ergonomic supports into your life. This might mean adjusting your desk setup to promote better posture or using tools designed to reduce strain on your joints. Maintaining a healthy weight is another key factor, as it lessens the overall stress on your body, including your shoulder joint. These small, intentional changes can collectively make a huge impact on your pain levels and daily function.

Physical Therapy

Physical therapy is a cornerstone of non-surgical shoulder care. A skilled physical therapist can design a personalized program to address your specific weaknesses and imbalances. The goal is to strengthen the muscles supporting your shoulder, which helps stabilize the joint and reduce the load on damaged tissues. Exercises focused on improving your range of motion can restore flexibility, while postural correction can alleviate the chronic strain that often contributes to shoulder problems. A therapist may also use manual techniques, like targeted massage and stretching, to directly address pain and restore proper movement, making it a powerful tool for functional improvement.

Chiropractic Care

If your shoulder pain is related to alignment issues, chiropractic care may offer a path to relief. Chiropractors focus on the relationship between your spine and nervous system, using precise adjustments to correct misalignments in the joints. By adjusting the spine and extremities, a chiropractor can help reduce nerve irritation, decrease inflammation, and improve your shoulder’s mechanics. This approach is centered on the idea that proper body structure is essential for proper function. For some, restoring alignment can significantly reduce pain and help the shoulder move more freely, making it a valuable component of a comprehensive conservative care plan.

Acupuncture and Massage Therapy

Complementary therapies like acupuncture and massage can also play a vital role in managing shoulder pain. Massage therapy focuses on the soft tissues—the muscles, tendons, and ligaments—surrounding your shoulder. It can be particularly helpful for injuries like a torn rotator cuff by releasing tension, improving circulation, and breaking down scar tissue, often working best alongside physical therapy. Acupuncture, a practice rooted in traditional medicine, uses thin needles inserted at specific points on the body. The goal is to stimulate these points to help reduce pain signals and improve how your shoulder functions, offering a different but often effective angle for pain relief.

Surgical Alternatives to Full Replacement

When conservative treatments aren’t providing enough relief but a full shoulder replacement feels like too big a step, there are other surgical options to consider. These procedures are typically less invasive than a total replacement and aim to preserve as much of your natural joint as possible. They target specific structural problems within the shoulder, offering a potential solution for people with certain types of severe damage who want to avoid a full arthroplasty. Exploring these alternatives with a surgeon can help you understand if there’s a middle-ground approach that fits your unique situation and goals.

Superior Capsule Reconstruction

For individuals with a severe or irreparable rotator cuff tear, a superior capsule reconstruction (SCR) can be a viable surgical alternative to a reverse total shoulder replacement. This innovative technique addresses the instability and dysfunction caused by a massive tear. During the procedure, a surgeon uses a graft—often taken from donor tissue—to reconstruct the superior capsule, which is a critical ligament-like structure at the top of the shoulder joint. By rebuilding this capsule, the surgery helps restore stability, improve shoulder mechanics, and reduce pain, allowing for better overall function without replacing the entire joint.

PRP and Stem Cells: A Viable Alternative to Shoulder Replacement?

In the worst case of shoulder replacement I have seen, an elderly man presented with right shoulder pain. When I asked him to lift his arms, he lifted his right arm, but had no motion at all in his left shoulder. I was perplexed and asked if his left shoulder also hurt. His response was alarming. He told me that he had a left shoulder replacement, and the arm prosthesis had dislocated out the the shoulder, and he had absolutely no use of his left arm since the dislocation that could not be relocated into the false joint. He obviously wanted to avoid surgery to his right shoulder.

We also see people who already had many surgeries and now so little is left of their shoulder they have to have a shoulder replacement. I myself had arthroscopic shoulder surgery many years ago. It did not help me and wore it took a year of rehab just to get it back to what it felt like just before the surgery. I see this in people all the time. They have a shoulder surgery, they rehab for a year, the shoulder still hurts, they have another shoulder surgery, they rehab for one year then it is deiced that they have reached the point of no return, shoulder replacement, they only decision left is reverse shoulder replacement or the regular procedure. So now that this person is waiting to get a shoulder replacement, what happens next? For some, cortisone injections to hold them over. Cortisone injections, as it has been demonstrated, can accelerate avascular necrosis or bone death. So a person has had two surgeries and they may have no cartilage left, now they are getting cortisone, now they will have no bone left.

Prolotherapy

Beyond PRP and stem cells, another established treatment to consider is Prolotherapy. This is a non-surgical regenerative option that aims to repair the weakened connective tissues that are often the source of chronic shoulder instability and pain. Think of it as a way to reinforce the natural “scaffolding” of your shoulder joint. When ligaments and tendons become loose or injured, the joint can become unstable, leading to painful movements and further degeneration. Prolotherapy directly addresses this underlying issue by stimulating the body to strengthen these crucial support structures, offering a path toward lasting stability and pain relief without the need for invasive procedures.

How Prolotherapy Works for Shoulder Pain

The concept behind Prolotherapy is elegantly simple: it triggers your body’s own healing mechanisms. The treatment involves injecting a natural solution, often containing a dextrose (sugar) base, into the precise locations where ligaments and tendons attach to the bone. This solution acts as a mild irritant, creating a localized inflammatory response. This isn’t the chronic inflammation you want to avoid; instead, it’s a controlled signal that tells your body, “Hey, this area needs repair!” In response, your body sends growth factors and other healing cells to the site, which work to rebuild and strengthen the injured tissue, resulting in tighter, stronger ligaments and a more stable shoulder joint.

Hyaluronic Acid Injections

Another option you might hear about is hyaluronic acid (HA) injections. Hyaluronic acid is a substance your body produces naturally; it’s a key component of the synovial fluid that lubricates your joints. In an arthritic shoulder, this fluid can thin out, leading to increased friction, grinding, and pain. Injecting HA directly into the shoulder capsule is like adding oil to a rusty hinge—it helps restore lubrication and cushioning, allowing the joint to move more smoothly and absorb shock more effectively. While HA can provide temporary relief for some, it doesn’t rebuild tissue. At our institute, we focus on treatments that stimulate the body’s own repair processes for more comprehensive results, but we can discuss if HA is a suitable part of your plan when you contact us for a consultation.

How Do Stem Cells Work to Repair Shoulder Damage?

A study (13)  in the The open orthopaedics journal from 2017 wrote: “The application of different growth factors and mesenchymal stem cells appears as promising approaches for enhancing biologic repair. However, data from clinical studies are still limited, and future studies need to improve understanding of the repair process in cellular and molecular level and evaluate the effectiveness of biologic factors in the management of shoulder disorders.”

The Darrow Stem Cell Institute has published research on the treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow derived stem cells.The research appears in the peer-reviewed journal Cogent Medicine. The study can be found here in its entirety: Treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow concentrate and whole bone marrow injections with a June 20, 2019 publication date.

An extended summary can be found here on our website: Treatment of shoulder osteoarthritis and rotator cuff tears.

The learning points of this research are as follows:

  • Patients who received either one and two treatments of bone marrow derived stem cells reported significant improvements in resting pain, active pain, and functionality score when compared to baseline.
  • These groups also experienced a 42.25% (one treatment) and 50.17% (two treatments) overall improvement respectively.
  • The group that received two treatments experienced statistically significant improvements in active pain when compared to the group that received one injection.
  • There were no significant outcome differences between rotator cuff tear and osteoarthritis patients.

Conclusions: Our study demonstrated that patients diagnosed with shoulder osteoarthritis or rotator cuff tears experienced symptomatic improvements in pain and functionality when injected with bone marrow concentrate (BMC) or whole bone marrow (WBM) . Further randomized control studies are needed to validate these findings.

  • Treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow concentrate and whole bone marrow injections

Learn More About Your Treatment Options

  • Rotator cuff tears – Stem cell therapy, PRP, cortisone and surgery
  • Shoulder Labrum tear | Labral repair and biceps tenodesis

 

 

1 Ödquist M, Hallberg K, Rahme H, Salomonsson B, Rosso A. Lower age increases the risk of revision for stemmed and resurfacing shoulder hemi arthroplasty: A study from the Swedish shoulder arthroplasty register. Acta orthopaedica. 2017 Dec 5:1-7.
2 Tashjian RZ, Hung M, Keener JD, Bowen RC, McAllister J, Chen W, Ebersole G, Granger EK, Chamberlain AM. Determining the minimal clinically important difference for the American Shoulder and Elbow Surgeons score, Simple Shoulder Test, and visual analog scale (VAS) measuring pain after shoulder arthroplasty. Journal of shoulder and elbow surgery. 2017 Jan 1;26(1):144-8.
3 Erşen A, Birişik F, Bayram S, Şahinkaya T, Demirel M, Atalar AC, Demirhan M. Isokinetic Evaluation of Shoulder Strength and Endurance after Reverse Shoulder Arthroplasty: A Comparative Study. Acta Orthop Traumatol Turc. 2019 Nov;53(6):452-456. doi: 10.1016/j.aott.2019.08.001. Epub 2019 Aug 19. PMID: 31439480; PMCID: PMC6939012.
4 MacInnes SJ, Mackie KE, Titchener A, Gibbons R, Wang AW. Activity following reverse total shoulder arthroplasty: What should surgeons be advising?. Shoulder & elbow. 2019 Jul;11(2_suppl):4-15.
5 Leschinger T, Raiss P, Loew M, Zeifang F. Total shoulder arthroplasty: risk factors for intraoperative and postoperative complications in patients with primary arthritis. J Shoulder Elbow Surg. 2017 Mar;26(3):e71-e77. doi: 10.1016/j.jse.2016.08.001. Epub 2016 Oct 10.
6 Tokish JM, Kissenberth MJ, Tolan SJ2, et al. Resilience correlates with outcomes after total shoulder arthroplasty. J Shoulder Elbow Surg. 2017 Feb 10. pii: S1058-2746(17)30012-5. doi: 10.1016/j.jse.2016.12.070.
7 Leschinger T, Raiss P, Loew M, Zeifang F. Predictors of medium-term clinical outcomes after total shoulder arthroplasty. Arch Orthop Trauma Surg. 2017 Feb;137(2):187-193. doi: 10.1007/s00402-016-2602-x. Epub 2016 Dec 7.
8 Robinson WA, Wagner ER, Cofield R, Sanchez-Sotelo J, Sperling JW. Long-term outcomes of humeral head replacement for the treatment of osteoarthritis; a report of 44 arthroplasties with minimum 10-year follow-up. Journal of shoulder and elbow surgery. 2017 Dec 18.
9 Lin DJ, Wong TT, Kazam JK. Shoulder Arthroplasty, from indications to complications: what the radiologist needs to know. Radiographics. 2016 Jan-Feb;36(1):192-208. doi: 10.1148/rg.2016150055.
10 Kany J, Jose J, Katz D, Werthel JD, Sekaran P, Amaravathi RS, Valenti P. The main cause of instability after unconstrained shoulder prosthesis is soft tissue deficiency. Journal of Shoulder and Elbow Surgery. 2017 Feb 27.
11 Ansari F, Lee T, Malito L, Martin A, Gunther SB, Harmsen S, Norris TR, Ries M, Van Citters D, Pruitt L. Analysis of severely fractured glenoid components: clinical consequences of biomechanics, design, and materials selection on implant performance. J Shoulder Elbow Surg. 2016 Jan 14. pii: S1058-2746(15)00588-1. doi: 10.1016/j.jse.2015.10.017
12 Giotis D, Aryaei A, Vasilakakos T, Paschos NK. Effectiveness of Biologic Factors in Shoulder Disorders. Open Orthop J. 2017;11:163–182. Published 2017 Feb 28. doi:10.2174/1874325001711010163
13 Cisneros LG, Atoun E, Abraham R, Tsvieli O, Bruguera J, Levy O. Revision shoulder arthroplasty: does the stem really matter? J. Shoulder Elbow Surg. 2016 Jan 25. pii: S1058-2746(15)00578-9. doi: 10.1016/j.jse.2015.10.007.

Frequently Asked Questions

My doctor says I need a shoulder replacement. How do I know if I’m a candidate for regenerative medicine instead? This is a common and important question. The best way to find out is through a direct consultation where we can review your specific case. Generally, good candidates for regenerative treatments still have a reasonable amount of healthy tissue and joint structure, even with arthritis or a rotator cuff tear. If you’re looking for a solution that helps your body heal the source of the problem, it’s worth exploring. We can give you a realistic assessment of whether our treatments can help you meet your goals before you commit to a major surgery.

What’s the main difference between PRP, Stem Cell Therapy, and Prolotherapy for the shoulder? Think of them as different tools for different aspects of shoulder repair, all focused on stimulating your body’s own healing ability. Prolotherapy is fantastic for strengthening the loose ligaments and tendons that cause joint instability. PRP uses a high concentration of your own platelets to deliver growth factors that kickstart repair in injured tissues, like a damaged rotator cuff. Stem Cell Therapy is often used for more significant cartilage damage from osteoarthritis, as it introduces your body’s own master repair cells to the area to help rebuild tissue. The right approach depends entirely on what’s causing your pain.

What does recovery look like after a regenerative procedure, and how soon can I expect to feel better? Unlike the lengthy and often difficult rehabilitation after surgery, recovery from regenerative injections is quite straightforward. Most people return to their normal daily lives immediately, though we typically recommend avoiding strenuous activity for a short time to let the healing process begin. This isn’t an overnight fix; these treatments work by prompting your body to rebuild tissue, which takes time. While some people feel relief within weeks, the most meaningful and lasting improvements usually build over the course of several months.

The post mentions weakness after surgery. Do regenerative treatments help restore shoulder strength? Yes, and this is a crucial difference. Shoulder replacement surgery cuts through muscles and can lead to a permanent loss of strength, particularly with rotation. Regenerative medicine takes the opposite approach. By healing the damaged tissues that support your shoulder—the ligaments, tendons, and cartilage—the goal is to restore the joint’s natural function and stability. As the joint becomes healthier and pain subsides, you can more effectively rebuild your own natural strength without the mechanical limitations of a prosthetic.

Is it possible to wait too long, where my shoulder is too damaged for these alternatives to work? There can be a point where the damage is too advanced for regenerative treatments to be the best option. This usually involves severe, bone-on-bone arthritis where the joint’s structure is significantly compromised. This is why we encourage people to look into these alternatives before their condition becomes extreme. An honest evaluation is key. We can assess your shoulder’s condition to determine if it still has the potential to heal and if regenerative medicine is a viable path for you.

Key Takeaways

  • Look Beyond the ‘Success’ of Surgery: A shoulder replacement isn’t always a permanent fix. Many patients still experience significant pain, weakness in rotation, and face the possibility of a more complicated revision surgery later on.
  • Heal from the Inside Out with Regenerative Options: Treatments like PRP and Stem Cell Therapy focus on repairing the root cause of your pain—the damaged ligaments and tendons. By stimulating your body’s own healing processes, these therapies aim to restore stability and function without replacing the joint.
  • Explore All Your Options Before Committing: Surgery should be the last resort, not the next step. A comprehensive plan involves trying conservative care first, then investigating if regenerative treatments can help you heal, giving you a chance to avoid an invasive procedure altogether.

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