Healing of partial tear of the supraspinatus tendon after at
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Injury of the rotator cuff tendon is one of the most common causes of pain and disability in the shoulder. There are several non-surgical treatments for this condition.

A 53-year-old female visited pain clinic with complaints of pain in the right shoulder and upper arm, lasting 1 month, with a numerical rating scale (NRS) intensity of 6. On physical examination, she had limited range of motion of the right shoulder due to the pain, which indicated painful arc syndrome. In addition, the Neer test and Hawkins–Kennedy test were positive with subacromial tenderness. Furthermore, she underwent MRI for the right shoulder prior to the initiation of treatment. The MRI result showed partial tears on the articular surface of the anterior supraspinatus tendon in the rotator cuff.

Based on an initial diagnosis of a rotator cuff tear, doctors treated the patient with suprascapular nerve blocks and subacromial-subdeltoid bursa injections containing 10 ml of 0.75% ropivacaine hydrochloride and 40 mg of triamcinolone. Several medications were also prescribed for pain control, including NSAIDs and a muscle relaxant. Within 1 week of treatment, the pain appeared to be relieved. However, she revisited pain clinic once a month with a complaint of pain worsening (NRS 8). Repetition of the aforementioned therapy did not lead to improvement in her symptoms.

Therefore, it was decided to inject type I collagen into the partial tear of the supraspinatus tendon. After preparing the skin to prevent infection, the partial tear of her supraspinatus tendon was scanned under ultrasound guidance. Subsequently, type I collagen (1 ml) mixed with 1 ml of 1% lidocaine into the location of the tear was injected. Type I collagen was re-injected in the same manner 1 month later.

Finally, MRI of the right shoulder was performed 2 months after the first injection of type I collagen. The results confirmed the healing of the previous partial thickness tear in the articular side of the supraspinatus tendon. Moreover, the patient reported a reduction in pain in the right shoulder (from NRS 8 to 2) and improvement in the movement of the shoulder. Six months later, the patient had not re-visited the hospital.

Source: https://journals.lww.com/md-journal/Fulltext/2020/12040/Healing_of_partial_tear_of_the_supraspinatus.94.aspx
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