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Rotator cuff repair treatments – all but Vitamin D need a prescription – Sept 2022


Pharmacologic Enhancement of Rotator Cuff Repair: A Narrative Review

Orthop Rev (Pavia). 2022 Sep 4;14(3):37782 doi: 10.52965/001c.37782. eCollection 2022.
Maksim Vaysman 1 , Matthew Alben 2 , Matthew Todd 3 , Charles Ruotolo 1

Introduction: As rotator cuff repairs (RCRs) are among the most common procedures in upper extremity orthopedics, healing augmentation using pharmacologic enhancement of the repaired rotator cuff muscle is of particular interest.

Objective: The purpose of this study is to review the current understanding of Matrix Metalloproteinases (MMPs), Doxycycline, Testosterone, Estrogen, Growth hormone/ IGF-1, Vitamin D, and Vitamin C as a means to mitigate deleterious effects and propagate factors that support healing following RCR.

Methods: A review of English language articles in PubMed and Medline was conducted in December of 2020. All articles describing the current understanding of the aforementioned therapies were reviewed. Studies were excluded if they were non-English or reported incomplete results.

Results: Matrix metalloproteinases (MMP's) are fundamental to the healing process after rotator cuff tears through a delicate balance of various proteases that can be modulated by doxycycline through inhibition. While testosterone has shown to induce replication and differentiation of the tendon stem-cells, estrogen agonists have been shown to decrease inflammation and muscle atrophy. Though growth hormone being associated with elevated collagen synthesis and decreased anoxic damage when present, clinical studies have shown inconclusive and adverse effects on rotator cuff healing. Patients with Vitamin D deficiency have shown to have increased fatty infiltration in rotator cuff muscle while Vitamin C functions as an antioxidant that increases collagen and fibroblast proliferation.

Conclusion: As manipulation of pharmacologic factors shows potential for enhancing healing following RCRs, future studies are needed to establish a viable augmentation strategy to improve patient outcomes.
 Download the PDF from VitaminDWiki


VitaminDWiki pages with ROTATOR in title (3 as of Sept 2022)

This list is automatically updated

Items found: 8

Anecdote: Vitamin D loading dose BEFORE rotator cuff surgery was great

A friend of the founder of VitaminDWiki was going to have rotator cuff surgery (2013)
I suggested that he get a Vitamin D loading dose before his surgery - which he did
His doctor reported that the subsequent surgery had the fastest recovery he had ever seen.


VitaminDWiki - 38 studies in both categories Trauma-Surgery and Loading Dose

This list is automatically updated


A few Vitamin D rotator cuff studies on the web

  • Vitamin D and the immunomodulation of rotator cuff injury - 2016;. doi: 10.2147/JIR.S106206 Free PDF
  • Preoperative Vitamin D Deficiency Is Associated With Higher Postoperative Complications in Arthroscopic Rotator Cuff Repair - 2019 doi: 10.5435/JAAOSGlobal-D-19-00075 - FREE PDF
  • Serum Vitamin D Correlates With Rotator Cuff Muscle Tissue Vitamin D And Muscle Performance Before And After Rotator Cuff Repair - 2022 DOI:https://doi.org/10.1016/j.jse.2022.01.028 Behind paywall
  • [Study on correlation between serum vitamin D level and the curative effect after repair of rotator cuff tears].- 2022 - DOI: 10.12200/j. Abstract is in English

VitaminDWiki - Trauma and surgery category contains

Trauma and Surgery category has 352 articles

Large dose Vitamin D before surgery was found to help by 35 studies
Vitamin D is needed before most surgeries – many studies and RCTs
4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024
Sepsis is both prevented and treated by Vitamin D - many studies
Thyroidectomy and Vitamin D - many studies
Orthopaedic surgeries need Vitamin D – many studies
Cancer - After diagnosis   chemotherapy
TBI OR "Traumatic Brain Injury - 21 in title as of Sept 2022
Superbug (Clostridium difficile) Infections strongly associated with low vitamin D - many studies
Glutamine and Omega-3 have also been proven to help several traumas/surgeries
   Note: Vitamin D also prevents the need for various surgeries and Omega-3 prevents many concussions/TBI
Trauma and Surgery is associated with 22 other VitaminDWiki categories
  Such as loading dose 33, Mortality 23, Infant-Child 21 Intervention 19 Cardiovascular 13, Injection 13 in Sept 2022


Created by admin. Last Modification: Tuesday June 13, 2023 14:25:01 GMT-0000 by admin. (Version 7)

Attached files

ID Name Comment Uploaded Size Downloads
18392 Rotator Cuff Repair.pdf admin 08 Sep, 2022 323.54 Kb 161