It’s no secret that a rodeo cowboy often gets breaks and bruises on the job. In the rough and tumble sport of rodeo – particularly bull riding and bareback riding – the risk of serious injury is just part of the gig. Research at Colorado State University is helping athletes such as these cowboys to overcome what may have been a career-ending injury several years ago. Finding innovative ways to bring athletes back from tendon injuries, particularly rotator cuff tears, is a focus of orthopedic researcher Dr. Simon Turner.
Turner, a veterinarian surgeon in the College of Veterinary Medicine and Biomedical Sciences, is looking at different suture patterns growth factors and biological implants to encourage better healing after surgery on rotator cuff injuries. He and his collaborators investigate new techniques to suture torn cuffs as well as the use of healing aids to improve recovery time. For example, Turner has teamed with Dr. Theodore Schlegel, a renowned surgeon at the Steadman Hawkins Denver Clinic, where Denver Broncos and Colorado Rockies players receive treatment for injuries including rotator cuff tears, to investigate new suture techniques that work well with arthroscopic repairs.
"Rotator cuff injuries are a common hazard encountered by a wide variety of professional athletes," Turner said. "And they are also common ailments among the elderly. Finding ways to improve treatments for these injuries can make a dramatic difference in the lives of athletes such as those who perform in rodeo arenas, on baseball diamonds, golf courses, tennis courts and football fields as well as the average person who experiences these injuries."
On average, recovery from rotator cuff surgery can take up to six months with a prescription of intense physical therapy. To a professional athlete who depends upon his arm for a living, six months is a long period of time, particularly after factoring in the age limitations of athletes in professional positions where rotator cuffs are common – rodeos cowboys, quarterbacks and pitchers, for example. In these competitive occupations, an athlete may be replaced on the roster by the time he heals.
In the past, surgeries to repair rotator cuffs are typically performed through a large incision. In recent years, an emerging trend toward arthroscopic surgery has shown success, Turner said. These changes have led to needed revisions in techniques, including finding new equipment to insert sutures and tie knots through small incisions, securing tendons and ligaments to the bone in the shoulder joint. The equipment helps to better secure stitches, preventing them from pulling out and causing additional damage to the joint as well as helping to quicken recovery.
Turner and his team also are investigating using a gel that contains a growth factor. The gel, made of substances typically produced within the human body that encourage healing, carries a mixture of proteins. The carrier is placed directly into the surgical incisions onto the wounded tissues. As the growth factor moves into surrounding tissues, it switches on certain populations of cells that are involved in healing the wound.
"Growth factors are being used more often in healing the human body and are used on everything from healing bone fractures to cartilage defects," Turner said. "The trick is to have the right growth factor in contact with the right cells. Some growth factors are potent to some cells but do nothing to other cells. We also are investigating what dosage of the growth factors work best on shoulder injuries as well as the benefits of different carriers of the growth factors. Sometimes, if there is too high a concentration of growth factors, it can actually have an opposite effect and switch off the cells’ ability to heal. It looks as if these substances work well in speeding up the healing process, allowing athletes – or any patient – to get back to their sport or activities sooner."
Research results within his program have been encouraging, Turner added. He tests the techniques on sheep within the College of Veterinary Medicine and Biomedical Sciences.
Turner and Schlegel’s research also produced a suture tool that is easily used during arthroscopic surgeries being used by surgeons within their practices today. The tool anchors a torn tendon to bone without the need to tie knots, which can be difficult to insert and are bulky.
Some growth factors are already on the market today and are approved for certain spine surgeries. Turner believes it will not be long before growth factors are available to enhance the healing of rotator cuff injuries.
The rotator cuff is a group of tendons and four muscles that surround and control the front, back and top of the shoulder joint. Rotator cuff injuries are very common, particularly among athletes in certain sports and the elderly. Rotator cuff injuries or tears are the result of a traumatic injury or repetitive use – performing the same activities time and time again – which eventually damages rotator cuff tendons and muscles.