Patch up a torn shoulder...with a cow’s Achilles

AN implant made from the Achilles heel of a cow is being used by surgeons to repair debilitating torn shoulder muscles, restoring movement to paralysed arms in just a fortnight.

The experimental patch is stapled over the damaged tissue, providing support while stimulating the body’s healing response.

One of the first patients to benefit, who underwent the procedure in March, says she’s now ‘back playing golf’. Louisa Maguire, 68, from Cheshire, had been suffering increasing pain for years due to a small yet growing tear in her rotator cuff, the group of four muscles that surrounds the shoulder joint and supports arm movement. Now, four months after the surgery, she says: ‘It feels like I have a new shoulder.’

In a small study of 23 patients with recurrent shoulder injuries, 21 of them regained full mobility and were pain-free a year after having the operation.

The postage stamp-sized implant was approved for use in the UK earlier this year. It is not available in Ireland as yet but thousands of patients in the US have undergone the procedure.

A third of adults aged over 50 develop rotator cuff tears, in which the fibrous tendons that anchor the muscles of the rotator cuff to the shoulder bones fray, and can even detach completely.

Common causes include repetitive arm movements — sportspeople and construction workers are often at risk — but the damage can be done simply by reaching up to a high shelf or pulling open a heavy door.

The muscles and tendons, particularly within the shoulders, stiffen with age, making tears more likely. Rotator cuff injuries are a very common reason for a visit to the GP. The majority are small partial tears, which can be treated simply with rest and ibuprofen.

However, once a tear occurs, they tend to worsen — 80 per cent get larger within two years, according to studies, and can even cause the arm to become almost paralysed. Previously, patients with severe tears would have surgery to pin the tendon back to the bone. But these procedures have had limited success, with 40 per cent of the nearly 50,000 patients who undergo surgery every year returning to their doctor with repeat problems.

Chris Peach, consultant shoulder and elbow surgeon at the OrthTeam Centre in Manchester, claims that while the older operation remedied the immediate problem, it did nothing to strengthen the muscle and prevent tears from recurring. He says: ‘Simply pinning damaged tissue back to the bone won’t solve the problem long term.’

The new patch is a ‘bioimplant’, derived from ‘purified bovine Achilles tendon’ — the tough tissue in the heel of a cow. It contains collagen — a protein in human and animal tissue vital for elasticity within tissues. During the healing process, the patch merges with the patient’s own rotator cuff, creating an extra layer of support for the recovering area as it heals.

The implant’s makers also claim it stimulates new, stronger tissue growth, making subsequent injuries less likely.