What causes shoulder pain? What is the current state-of-the-art treatment for these conditions? In a recent seminar, Dr. Gregory highlighted answers to these questions for a large group of interested community members. Many causes of shoulder pain exist, including rotator cuff injury, labral tears, arthritis, or frozen shoulder. Many of these conditions can be treated non-operatively if caught early enough, but the key is making the right diagnosis. Treatments such as platelet rich plasma (PRP) or stem cells are increasingly marketed as a cure all for these conditions, but are they worth your money? Seeing a dedicated shoulder and elbow specialist like Dr. Gregory, can help sort fact from fiction, and help get the diagnosis correct the first time.
At the 2019 Annual Meeting of the American Orthopedic Society for Sports Medicine (AOSSM) in Boston, Dr. Gregory presented his research identifying stem cells within the subacromial bursa tissue in the shoulder. The subacromial bursa is tissue found overlying the rotator cuff, and is normally discarded during rotator cuff surgery. Stem cells are cells that have the capability to significant improve the body’s healing response. By identifying that bursal tissue possesses a rich pool of stem cells, Dr. Gregory hopes to develop a way to preserve this tissue during rotator cuff repair to help improve the body’s natural healing response.
When performing a shoulder replacement, surgeons strive to recreate normal anatomy, in the hopes that this will improve surgical outcomes. In the recent edition of Orthopedics Today magazine, Dr. Gregory provided his commentary on a new research article showing that stemless shoulder replacements, which do not have a piece of metal that goes down into the arm bone (humerus), may be better able to restore patients’ normal anatomy. In his clinical practice, Dr. Gregory uses stemless shoulder replacements when appropriate for this very reason. Improving outcomes of shoulder surgery is very important, and Dr. Gregory remains passionate about using the most up-to-date technology to help with this.
As part of Dr. Gregory’s desire to improve our understanding of rotator cuff treatment, he has worked with collaborators to apply a new MRI technique to examination of the rotator cuff. This new MRI technique, called ultra-short time-to-echo (UTE) MRI, has the potential to better determine the quality of the rotator cuff tendon, not just whether it is torn. This research was presented at the 2019 Annual Meeting of the Orthopaedic Research Society, and by helping to improve our MRIs, has the potential to help improve the treatment of rotator cuff tears as well.
At the 2019 Annual Meeting of the Orthopaedic Research Society (ORS), Dr. Gregory and his collaborators presented research demonstrating that subacromial bursa tissue is very rich in mesenchymal stem cells. The subacromial bursa is tissue found overlying the rotator cuff, and is normally discarded during rotator cuff surgery. Stem cells are cells that have the capability to significant improve the body’s healing response. By identifying that bursal tissue possesses a rich pool of stem cells, Dr. Gregory hopes to develop a way to preserve this tissue during rotator cuff repair to help improve the body’s natural healing response.
Over the next two days, shoulder surgeons from across the country will come to Houston for the 62nd Annual Edward T. Smith Orthopaedic Lectureship, entitled “A Comprehensive Approach to the Shoulder: Arthroscopy, Arthroplasty, and Fracture Care”. Dr. Gregory is one of the course directors for this meeting, and organized this conference to provide regional surgeons the opportunity to hear from nationally and internationally experts regarding the management of common shoulder conditions. Dr. Gregory specifically will be discussing several topics, including using stem cells and PRP to augment rotator cuff repair, managing arthritis in the young patient, and using reverse shoulder replacements to treat severe shoulder fractures.