Orthopedic regenerative sports medicine: email@example.com
Dr. Kelly Cunningham and the team at Austin Ortho+Biologics have developed a focused and reproducible strategy for dealing with orthopedic problems of the shoulder.
Through years of research and literature review, clinical orthopedic practice and evaluation of results, methods of treatment have evolved to deal with various common injuries, often in mature athletes.
These biologic techniques can be used as a stand-alone procedure or in combination with outpatient shoulder surgery:
Shoulder Injury Treatment Recommendation
Rotator cuff tear
Partial <50% PRP or MSC*
>50% PRP + surgical repair (failed PT trial^)
Complete small (<2 cm) PRP + surgical repair ^
mod/large (>2 cm) MSC + surgical repair ^
notes: PRP (Platelet-Rich Plasma injection, patient-derived) has demonstrated an ability to relieve pain, improve function & provide growth factors to rotator cuff injury - in contrast to steroid injection, which may limit healing & treatment options
Cellular therapy (MSC “stem cell” injection, patient-derived/bone marrow) appears to improve surgical healing in larger full-thickness tears, and may allow healing of partial/smaller tears without surgery *
PT trial = an initial course of Physical Therapy, based on patient-specific activity, to attempt to delay/avoid surgery ^
Mild PRP + PT, activity modification
Moderate/severe MSC + PT, activity modification
if positive MRI findings, surgery “clean-up”+ MSC
notes: PRP, MSC with successful pain relief is based on similar use/studies in the arthritic knee, enhanced by the non-weight-bearing status of the shoulder
excellent results often obtained with or without combined surgery, which is indicated in younger or more active patients with “mechanical” symptoms of labral tear, loose bodies (as noted on MRI) and/or capsule contracture that limits motion
severe arthritis may eventually need joint replacement, but biologics offers a chance to delay or even avoid such an aggressive surgery
Labral (“cartilage rim”) tears, biceps disease
Pain only PRP
Pain + mechanical symptoms surgical repair + PRP
notes: “mech symptoms” are catching, locking, dislocation of the tendon; affecting activities
PRP provides growth factors that aid in healing surgical repair
biceps reattachment may be indicated for recurrent labral tears or torn biceps, especially at a certain age
Dr. Cunningham is a board-certified, fellowship-trained orthopedic surgeon with special interest in the treatment of cartilage injuries and degeneration of the shoulder, knee, hip and elbow.
He focuses on non-surgical and surgical care of his patients, using innovative and cutting-edge regenerative sports medicine techniques. He has practiced in Austin, Texas, for over 30 years.