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

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

Bonnie McRae, Jane Fitzpatrick, Hussain Khan

McRae – Australasian College of Sport & Exercise Medicine, Griffith University. Fitzpatrick – University of Melbourne, Australasian College of Sport & Exercise Medicine, Joint Health Institute. Khan – Australasian College of Sport & Exercise Medicine, Olympic Park Sports Medicine Centre

International-Journal-of-Case-Reports-2d code

The use of injectable cell therapies to treat tendon pathology has become significantly more popular in recent years. They are appealing treatment modalities as they are minimally invasive, autologous, non-surgical management options which theoretically allow tendon regeneration and return to function. This case report will focus on the use of autologous tenocyte implantation (ATI) injection therapy to treat chronic degenerative rotator cuff tendinopathy.

Keywords: autologous tenocyte implantation, chronic rotator cuff tendinopathy, cell therapy

Free Full-text PDF

How to cite this article:

Bonnie McRae, Jane Fitzpatrick, Hussain Khan.Autologous Tenocyte Implantation for the Treatment of Chronic Degenerative Rotator Cuff Tendinopathy. International Journal of Case Reports, 2020 4:124. DOI: 10.28933/ijcr-2020-02-0805


1. Khan KM, Cook JL, Bonar F, et al. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med 1999;27(6):393-408. doi: 10.2165/00007256-199927060-00004
2. Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 2009;43(6):409-16. doi: 10.1136/bjsm.2008.051193
3. Young M. Stem cell applications in tendon disorders: a clinical perspective. Stem Cells Int 2012;2012:637836. doi: 10.1155/2012/637836
4. Wu B, Chen J, Dela Rosa T, et al. Cellular response and extracellular matrix breakdown in rotator cuff tendon rupture. Arch Orthop Trauma Surg 2011;131(3):405-11. doi: 10.1007/s00402-010-1157-5
5. Bhabra G, Wang A, Ebert JR, et al. Lateral Elbow Tendinopathy: Development of a Pathophysiology-Based Treatment Algorithm. Orthop J Sports Med 2016;4(11):2325967116670635. doi: 10.1177/2325967116670635 published Online First: 2016/11/12
6. Chen J, Wang A, Xu J, et al. In chronic lateral epicondylitis, apoptosis and autophagic cell death occur in the extensor carpi radialis brevis tendon. J Shoulder Elbow Surg 2010;19(3):355-62. doi: 10.1016/j.jse.2009.07.064 published Online First: 2009/10/20
7. Hsu J, Keener JD. Natural History of Rotator Cuff Disease and Implications on Management. Oper Tech Orthop 2015;25(1):2-9. doi: 10.1053/j.oto.2014.11.006
8. Schwab LM, Blanch P, Young M. Autologous tenocyte implantation into shoulder tendon pathology in an elite swimmer. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine 2018;29:19-25. doi: 10.1016/j.ptsp.2017.10.004 published Online First: 2017/11/21
9. Wang AW, Bauer S, Goonatillake M, et al. Autologous tenocyte implantation, a novel treatment for partial-thickness rotator cuff tear and tendinopathy in an elite athlete. BMJ case reports 2013;2013 doi: 10.1136/bcr-2012-007899 published Online First: 2013/01/15
10. Bucher TA, Ebert JR, Smith A, et al. Autologous Tenocyte Injection for the Treatment of Chronic Recalcitrant Gluteal Tendinopathy: A Prospective Pilot Study. Orthop J Sports Med 2017;5(2):2325967116688866. doi: 10.1177/2325967116688866
11. Wang A, Mackie K, Breidahl W, et al. Evidence for the Durability of Autologous Tenocyte Injection for Treatment of Chronic Resistant Lateral Epicondylitis: Mean 4.5-Year Clinical Follow-up. Am J Sports Med 2015;43(7):1775-83. doi: 10.1177/0363546515579185
12. Wang A, Breidahl W, Mackie KE, et al. Autologous tenocyte injection for the treatment of severe, chronic resistant lateral epicondylitis: a pilot study. Am J Sports Med 2013;41(12):2925-32. doi: 10.1177/0363546513504285
13. Morag Y, Jamadar DA, Miller B, et al. The subscapularis: anatomy, injury, and imaging. Skeletal Radiol 2011;40(3):255-69. doi: 10.1007/s00256-009-0845-0
14. Sein ML, Walton J, Linklater J, et al. Reliability of MRI assessment of supraspinatus tendinopathy. Br J Sports Med 2007;41(8):e9. doi: 10.1136/bjsm.2006.034421
15. Ho JO, Sawadkar P, Mudera V. A review on the use of cell therapy in the treatment of tendon disease and injuries. J Tissue Eng 2014;5:2041731414549678. doi: 10.1177/2041731414549678
16. Vailas AC, Tipton CM, Laughlin HL, et al. Physical activity and hypophysectomy on the aerobic capacity of ligaments and tendons. J Appl Physiol Respir Environ Exerc Physiol 1978;44(4):542-6. doi: 10.1152/jappl.1978.44.4.542
17. Kannus P, Jozsa L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 1991;73(10):1507-25.
18. Harvie P, Ostlere SJ, Teh J, et al. Genetic influences in the aetiology of tears of the rotator cuff. Sibling risk of a full-thickness tear. J Bone Joint Surg Br 2004;86(5):696-700.
19. Tashjian RZ, Farnham JM, Albright FS, et al. Evidence for an inherited predisposition contributing to the risk for rotator cuff disease. J Bone Joint Surg Am 2009;91(5):1136-42. doi: 10.2106/JBJS.H.00831
20. Gwilym SE, Watkins B, Cooper CD, et al. Genetic influences in the progression of tears of the rotator cuff. J Bone Joint Surg Br 2009;91(7):915-7. doi: 10.1302/0301-620X.91B7.22353
21. Andres BM, Murrell GA. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res 2008;466(7):1539-54. doi: 10.1007/s11999-008-0260-1
22. Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet 2010;376(9754):1751-67. doi: 10.1016/S0140-6736(10)61160-9
23. de Vos RJ, Weir A, van Schie HT, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 2010;303(2):144-9. doi: 10.1001/jama.2009.1986
24. Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 2003(1):CD004016. doi: 10.1002/14651858.CD004016
25. Saltzman BM, Jain A, Campbell KA, et al. Does the Use of Platelet-Rich Plasma at the Time of Surgery Improve Clinical Outcomes in Arthroscopic Rotator Cuff Repair When Compared With Control Cohorts? A Systematic Review of Meta-analyses. Arthroscopy 2016;32(5):906-18. doi: 10.1016/j.arthro.2015.10.007
26. Castricini R, Longo UG, De Benedetto M, et al. Platelet-rich plasma augmentation for arthroscopic rotator cuff repair: a randomized controlled trial. Am J Sports Med 2011;39(2):258-65. doi: 10.1177/0363546510390780
27. Randelli P, Arrigoni P, Ragone V, et al. Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Shoulder Elbow Surg 2011;20(4):518-28. doi: 10.1016/j.jse.2011.02.008
28. Ellera Gomes JL, da Silva RC, Silla LM, et al. Conventional rotator cuff repair complemented by the aid of mononuclear autologous stem cells. Knee Surg Sports Traumatol Arthrosc 2012;20(2):373-7. doi: 10.1007/s00167-011-1607-9
29. Chen J, Yu Q, Wu B, et al. Autologous tenocyte therapy for experimental Achilles tendinopathy in a rabbit model. Tissue Eng Part A 2011;17(15-16):2037-48. doi: 10.1089/ten.TEA.2010.0492
30. Chen JM, Willers C, Xu J, et al. Autologous tenocyte therapy using porcine-derived bioscaffolds for massive rotator cuff defect in rabbits. Tissue Eng 2007;13(7):1479-91. doi: 10.1089/ten.2006.0266

Terms of Use/Privacy Policy/ Disclaimer/ Other Policies:
You agree that by using our site, you have read, understood, and agreed to be bound by all of our terms of use/privacy policy/ disclaimer/ other policies (click here for details).

This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.