‘Sling’ made of skin cells to soothe a sore shoulder

A‘Sling’ made from donated skin is being used to help patients who suffer from chronic shoulder pain. the patch, inserted via a small incision, goes around torn rotator cuffs — a group of four muscles and tendons which surround the shoulder joint — to create a scaffold around which healthy tissue can grow to repair the tear.

new research shows the treatment can repair the damage and more than halve symptoms of the condition, which affects around one in five people in the UK.

the rotator cuff secures the upper arm bone firmly inside the shoulder socket. the tendons help keep the shoulder stabilised while enabling the arms to be rotated.

Common rotator cuff injuries include tendonitis — where tendons become inflamed through overuse — and bursitis, where a fluid-filled pad that cushions the tendons becomes inflamed.

With most rotator cuff tears, a tendon is torn away from the bone. in many cases, torn tendons begin by fraying, and may then completely tear, often after lifting a heavy object.

Part of the shoulder blade can rub against soft tissue, causing pain — raising an arm above the head can even become impossible. you can be more at risk if your job involves lifting or if you play a sport involving repetitive shoulder movements, such as swimming.

Rheumatoid arthritis and osteoarthritis can also raise the risk. A study by germany’s Saarland University found 13 per cent of those in their 50s have evidence of tears. this rises to 20 per cent in their 60s, 31 per cent in their 70s, and 51 per cent in their 80s.

initial treatment can include physiotherapy and anti-inflammatory drugs to reduce pain. but in some cases surgery remains the only option. this usually involves debridement, where any inflamed or loose tissue and bone spurs are removed. then the torn tendon is sewn back on to the bone.

but often the tear is too large and the joint too stiff, and the tendon cannot be stretched back to the bone, making repair difficult or impossible. With ageing, tendons and muscles can also deteriorate, making them unsuitable for stretching and stitching.

the new treatment, known as the graftJacket, reinforces the tissue and prevents future tears. it is made from human skin that has been processed to remove all the cells to prevent rejection.

it is stitched into place over the tear, and the patient’s own tissue then grows to repair the injury, forming a stronger rotator cuff.

the manufacturer is also testing it as a treatment for Achilles tendon repairs, as well as for use in hip and knee replacements. in a recent study at Hereford Hospital, 20 patients with rotator cuff tears were treated with the sling. Results showed symptoms improved significantly after 18 months.

Furthermore, 85.7 per cent of the patients returned to work within four months, and 93.8 per cent were driving again after eight, according to the Journal Of Orthopaedics.

Commenting on the approach, Roger Hackney, a consultant orthopaedic surgeon at leeds teaching Hospitals and Spire leeds Hospital, said: ‘the problem with human skin is that it can take time for the surrounding tissue to grow into it, which is needed for proper healing, and the results of microscopic examination can show adverse tissue reactions.

‘this study looked at short-term results and it will be interesting to see longer-term outcomes.’