This transcript is from a video conversation (Dr. Joshua John-Ram Schacter and another speaker) describing conventional management of partial-thickness rotator cuff tears (conservative therapy, steroid injection, physical therapy, then possible outpatient surgery with prolonged recovery) and contrasting it with orthobiologic, ultrasound-guided nonsurgical injections that aim to directly heal the tendon with shorter in-office procedures and much faster return to activity.
Chapters
Say you were going to do a rotator cuff repair on a partial thickness rotator cuff tear. The way that that works is you come to your regular doctor, you have a partial thickness rotator cuff tear, which doesn't necessarily always need surgery. But if it continues to be symptomatic, then oftentimes we'll recommend that your normal treatment plan through a normal orthopedic office would be you'd come in, he'd be evaluated by your orthopedic surgeon, he'd notice that you don't have a full thickness rotator cuff tear, so you're a candidate for therapy. So then we start some therapy. Maybe we give you a steroid injection, which is terrible because steroid damages our tissue, but steroid does help a lot with the symptoms. So typically your treatment would be a steroid injection and then physical therapy for up to three months.
If the physical therapy then doesn't necessarily.
Work or you continue to have significant pain, you come back to your orthopedic surgeon's office, maybe you'll see him for another 15 minutes, and then he'll recommend a surgery.
The surgery itself takes us about an hour and a half to do.
It's outpatient, it's in and out the same day. Unfortunately, it's very, very inconvenient because oftentimes we have to go in and repair the tear if we weren't able to heal it with other measures. So then you're gonna be in a sling for about six weeks. You're going to be not lifting anything more than ten pounds for three months.
And oftentimes after a rotator cuff repair.
Surgery of this type, you can continue to improve for up to a year, to a year and a half before you reach your point of maximum improvement. Well, with orthobiologics, we skip all of that. We can focus in direct healing using ultrasound guidance with an injection. Takes us about 45 minutes or an hour to do in the office. The entire procedure is about an hour long.
Then we often will ask our patients maybe to take it easy for about two to three weeks. In some cases where we have longer.
Treatments that can be six weeks or even longer. But the vast majority of people who receive orthobiologist treatments, we basically ask them to take it easy for a couple of weeks and then ease back into their more normal activities. We find that this returns patients very, very quickly to their normal activities and particularly their sports, without any of the downtime or significant risk of an orthopedic surgery.
