Autologous tenocyte implantation into shoulder tendon pathology in an elite swimmer

Autologous Tenocyte Implantation for the Treatment of Chronic Degenerative Rotator Cuff Tendinopathy

“…corticosteroids and Platelet-Rich Plasma (PRP)) in tendinopathy. 8 Whilst corticosteroid injection therapy studies have demonstrated short-term benefits of pain relief and improved function, long-term study results tend to report a return of pain, worsening of symptoms, and tendon atrophy and even rupture. 22 24 Regenerative approaches for tendinopathy include treatment with autologous blood, plasma, or cells (such as autologous mesenchymal stem cells, skin fibroblasts, or tenocytes).…”

“…Mandatory venous blood sampling is also performed to screen for infection, syphilis, hepatitis, and human immunodeficiency virus prior to the patient being accepted for treatment. 8 Tendon cells are cultured over 4-5 weeks in a scaffold medium and stored until implantation is carried out via ultrasound guided injection into the affected tendon area. 8 ATI is seen as a less invasive technique to use before resorting to operative intervention.8 It attempts to restore cellular density and counteract the slow rate of healing in tendon injuries by injecting the patient's own cultured tenocyte cells back into the damaged tendon.…”

“…8 Tendon cells are cultured over 4-5 weeks in a scaffold medium and stored until implantation is carried out via ultrasound guided injection into the affected tendon area. 8 ATI is seen as a less invasive technique to use before resorting to operative intervention.8 It attempts to restore cellular density and counteract the slow rate of healing in tendon injuries by injecting the patient's own cultured tenocyte cells back into the damaged tendon. 9 29 It is designed to improve tendon regeneration rather than repair in tendinopathy and tears.…”

“…29 30 Previous studies using ATI have shown promising results for the treatment of lateral elbow, gluteal, and shoulder tendinopathy, with improvement noted in pain, strength, and function in both human and animal studies. [8][9][10][11] Whilst not all studies demonstrated MRI changes following ATI injection, 10 11 one recent study demonstrated both improved clinical and radiological outcomes in patients with rotator cuff injuries following ATI. 9 Whilst the patient in our study made excellent clinical improvements following ATI, there are several limitations to this case report.…”

“…Autologous tenocyte implantation (ATI) is a minimally-invasive, bioengineered treat-ment that is designed to address the underlying pathology of chronic degenerative ten-dinopathy by replenishing the local tenocyte population with cultured autologous tenocytes. The Australian Therapeutic Goods Administration approved the manufacture and supply of ATI in 2010, and promising results have been obtained in human studies of lateral epicondylitis, gluteal tendinopathy [8][9][10][11][12] and rotator cuff tendinopathy in elite athletes. 8 9…”