CPT® Code 0718T

1. Indications

The autologous adipose-derived regenerative cell (ADRC) therapy is indicated for the treatment of partial thickness rotator cuff tears. This procedure is particularly relevant for patients who have not achieved satisfactory results from conservative treatments such as physical therapy or steroid injections, which primarily address symptoms rather than the underlying structural damage. Additionally, it may be considered for individuals who are at risk of re-rupture following surgical interventions, given the rotator cuff's known poor healing response.

• Partial Thickness Rotator Cuff Tear This procedure is specifically designed to treat tears in the rotator cuff that do not extend completely through the tendon.

2. Procedure

The procedure for autologous adipose-derived regenerative cell (ADRC) therapy involves several critical steps to ensure the effective treatment of partial thickness rotator cuff tears.

• Step 1: Harvesting of Adipose Tissue The first step involves the collection of adipose tissue from the patient, typically performed through liposuction. This is done under local anesthesia to minimize discomfort. Common donor sites include the trunk or thigh, where sufficient fat can be safely harvested.
• Step 2: Processing of Adipose Tissue After harvesting, the lipoaspirate is allowed to rest, enabling the adipose tissue to separate. The tissue is then incubated with an enzymatic reagent, which aids in the isolation and dissociation of the cells. Following this, the adipose tissue undergoes a series of processing steps, including filtration, washing, and centrifugation, to prepare the regenerative cells for injection.
• Step 3: Injection into the Supraspinatus Tendon Once the autologous stem cell product is prepared, it is injected into the supraspinatus tendon and the surrounding area. This injection is performed using an appropriate gauge needle and is guided by ultrasound to ensure accurate placement of the regenerative cells. After the injection, the site is dressed to support healing.

3. Post-Procedure

Post-procedure care for patients undergoing autologous adipose-derived regenerative cell (ADRC) therapy typically includes monitoring the injection site for any signs of complications, such as infection or excessive swelling. Patients may be advised to limit shoulder movement for a specified period to allow for optimal healing. Follow-up appointments are essential to assess the effectiveness of the treatment and to monitor recovery progress. While the procedure shows promise, ongoing clinical trials will continue to evaluate its long-term efficacy and safety.