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Calcific Tendinitis of the Rotator Cuff (CTRC)

Calcific Tendinitis of the Rotator Cuff (CTRC)

Mar 13, 2025

Calcific tendinitis of the rotator cuff (CTRC) is the accumulation of calcium phosphate within a tendon and is often chronic and recurrent. The majority of CTRC cases are located within 1–2 cm of the insertion of the supraspinatus, leading to a restricted range of motion in the shoulder and potentially causing severe pain (Maja et al., 2023). Interestingly, CTRC commonly occurs between the ages of 30 and 50 and is twice as likely to affect women (Kim et al., 2020). There are two proposed theories regarding the formation of CTRC: the degenerative theory and the reactive theory. The degenerative theory suggests that age-related changes in the tendon lead to a reduction in blood vessel distribution. This results in a hypoxic environment, causing necrosis and/or tendon tearing, which can subsequently lead to calcification (Kim et al., 2020). The reactive theory, on the other hand, describes three phases of calcification: the precalcific phase, the calcific phase, and the post-calcific phase. The precalcific phase involves the ‘transformation of the tendon into fibrocartilaginous tissue’ (Maja et al., 2023), facilitating calcium deposition. The calcific phase is when the actual deposition of calcium occurs, while the post-calcific phase involves the remodelling of the tendon around the calcium deposit. However, neither theory has been definitively proven (Maja et al., 2023). Secondary complications such as bursitis and synovitis are common in CTRC due to the chemical irritation caused by calcium deposits. Treatment for CTRC can be either conservative or surgical. Conservative management has a success rate of 30–80%. Non-steroidal anti-inflammatory drugs (NSAIDs) provide effective pain relief, and corticosteroid injections are beneficial during the resorptive phase. Barbotage has been shown to relieve pain in 70% of patients due to its decompression effects. Ultrasound therapy has also been found to improve quality of life and pain relief; however, it requires regular attendance over a six-week period. Extracorporeal shockwave therapy (ESWT) has the highest success rate for chronic calcific tendinitis and achieves results comparable to surgery (Kim et al., 2020). ESWT is effective in improving function and reducing pain, with greater efficacy when combined with physiotherapy (Maja et al., 2023). Therefore, conservative treatment should be prioritised and implemented for at least six months before considering surgical intervention (Maja et al., 2023). If you are experiencing symptoms of calcific tendinitis, it is important to seek professional medical advice. Booking an appointment with sports medicine doctor Dr David Porter (link to bio) can help you explore a range of treatment options tailored to your specific condition. Early intervention and expert guidance can significantly improve your recovery and long-term shoulder health.

Reference List

Kim, M.-S., Kim, I.-W., Lee, S. and Shin, S.-J. (2020). Diagnosis and treatment of calcific tendinitis of the shoulder. Clinics in Shoulder and Elbow, [online] 23(4), pp.203–209. doi:https://doi.org/10.5397/cise.2020.00318. Маја Manoleva, Erieta Nikolic Dimitrova, Koevska, V., Biljana Mitrevska, Marija Gocevska Gjerakaroska, Cvetanka Savevska, Biljana Kalchovska Ivanovska, Lidija Stojanoska Matjanoska, Gecevska, D., Jugova, T. and Liljana Malinovska Nikolovska (2023). Comparison of Immediate Effects of Extracorporeal Shockwave Therapy and Conventional Physical Therapy in Patients with Calcific Tendinitis of the Shoulder Rotator Cuff. Academic Medical Journal, 3(1), pp.99–109. doi:https://doi.org/10.53582/amj2331099m.
A New Approach to Managing Osteoarthritis: The Role of Stem Cell Therapy and Regenerative Medicine

A New Approach to Managing Osteoarthritis: The Role of Stem Cell Therapy and Regenerative Medicine

Feb 21, 2025

Understanding Osteoarthritis and Its Impact

Osteoarthritis (OA) is one of the most common joint conditions, affecting millions of people worldwide. It develops when the protective cartilage that cushions the joints gradually wears away, leading to pain, stiffness, and reduced mobility. Over time, the condition can significantly impact daily activities, making tasks such as walking, climbing stairs, or even getting out of bed challenging.

Traditional treatments for OA include pain relief medications, physiotherapy , steroid injections, and, in severe cases, joint replacement surgery. While these treatments help manage symptoms, they do not address the underlying cause, cartilage loss. This has led to growing interest in regenerative medicine, an emerging field focused on helping the body repair itself.

One area of regenerative medicine that has gained attention in recent years is stem cell therapy . Although this treatment is still undergoing research and development, early findings suggest it may offer a new approach to joint health by supporting tissue repair and reducing inflammation.

What Are Stem Cells?

Stem cells are special types of cells that have the potential to develop into different cell types in the body. This ability makes them important for healing and regeneration. The human body contains various types of stem cells, but mesenchymal stem cells (MSCs) are of particular interest when it comes to joint health.

MSCs can be obtained from several sources, including:

  • Bone marrow (from inside bones)
  • Adipose tissue (fat cells)
  • Umbilical cord tissue (from donated umbilical cords after birth)

Among these, umbilical cord-derived MSCs (UC-MSCs) have been widely studied for their potential role in joint repair.

How Can Stem Cells Help in Osteoarthritis?

While osteoarthritis is typically considered irreversible, ongoing research is exploring how stem cells might help slow its progression, reduce symptoms, and potentially support cartilage repair.

The Role of UC-MSCs in Joint Health

Umbilical cord-derived mesenchymal stem cells (UC-MSCs) are being studied for their ability to:

  • Reduce inflammation in the joint – Inflammation plays a key role in osteoarthritis and contributes to pain and stiffness.
  • Support cartilage maintenance – While research is ongoing, UC-MSCs are believed to release factors that encourage cartilage cells to survive and function.
  • Improve joint lubrication – UC-MSCs may help enhance the quality of synovial fluid, the natural lubricant in joints, improving movement.
  • Modulate the immune system – Osteoarthritis has been linked to immune system activity. UC-MSCs have the potential to balance immune responses in the joint.

Research into UC-MSCs is still ongoing, and while early results are promising, more studies are needed to determine their long-term effects and optimal use.

What Does the Latest Research Say?

Over the past few years, several studies have explored the potential of umbilical cord-derived stem cells in osteoarthritis treatment. Some notable findings include:

  1. Potential for Knee Cartilage Repair
    A review published in Medicine (2025) examined the use of UC-MSCs for knee osteoarthritis. The study found that these cells may contribute to reduced pain, improved function, and potential cartilage preservation. (Liao et al., 2025).
    📄 Read More: LWW Journal
  2. Stem Cell-Based Hydrogels for Cartilage Support
    A study in ACS Biomaterials Science (2025) investigated biodegradable hydrogels combined with UC-MSCs to enhance cartilage repair. The findings suggested improved joint function and reduced inflammation. (Ghosal et al., 2025).
    📄 Read More: ACS Publications
  3. Exosome Therapy for Osteoarthritis
    Scientists are also studying exosomes—tiny particles released by UC-MSCs – which may have anti-inflammatory and regenerative effects. A study in Advanced Functional Materials (2025) showed that exosomes from UC-MSCs supported cartilage repair and joint function in osteoarthritis models. (Lv et al., 2025).
    📄 Read More: Wiley Online Library
  4. UC-MSCs and Joint Injections
    Clinical trials published in Stem Cell Research & Therapy (2025) evaluated the safety and effects of UC-MSC injections for knee OA. The study noted improvements in pain, mobility, and joint function after six months. (Lei et al., 2025).
    📄 Read More: Springer

These studies represent a growing body of research exploring how stem cells may contribute to joint health and osteoarthritis management.

Important Considerations

While the idea of regenerative treatments for osteoarthritis is exciting, there are a few important points to keep in mind:

1. Research is Ongoing

Stem cell treatments, including those using umbilical cord-derived stem cells, are still being researched. Scientists continue to investigate their effectiveness, best application methods, and long-term safety.

2. Treatments Are Not Yet Widely Approved

While some countries have introduced regenerative medicine into clinical practice, regulatory authorities such as the UK’s MHRA (Medicines and Healthcare products Regulatory Agency) are still assessing these treatments. Opus, unlike many other clinics, is the UKs only licenced and regulated provider. It is essential to stay informed and seek advice from medical professionals before considering any new treatment options.

3. Every Patient is Different

Osteoarthritis can vary widely between individuals, meaning that treatment responses may differ. What works for one person may not work in the same way for another.

4. A Holistic Approach is Best

Stem cell therapy, if proven to be effective in the future, is unlikely to be a standalone cure for osteoarthritis. It is always best considered alongside other approaches such as:

  • Maintaining a healthy weight to reduce joint strain.
  • Engaging in regular, low-impact exercise (such as swimming or cycling).
  • Using joint-friendly supplements (such as glucosamine and omega-3 fatty acids).
  • Following a balanced diet to support joint health.

 

The Future of Regenerative Medicine

Research into umbilical cord-derived stem cells for osteoarthritis is advancing rapidly, with promising early results. Scientists are also exploring combination therapies, including:

  • Stem cells with growth factors to enhance repair.
  • 3D-printed cartilage scaffolds to create personalised joint implants.
  • Gene editing to enhance stem cell performance.

As research continues, the goal is to develop treatments that not only relieve symptoms but also support the long-term health of joints.

Conclusion

Osteoarthritis remains a challenging condition, but advances in stem cell research and regenerative medicine are opening up new possibilities. While umbilical cord-derived stem cells are still being studied, they hold promise as a potential tool for reducing inflammation, supporting joint function, and promoting cartilage health.

For now, education and staying informed about scientific advancements are key. As more research emerges, individuals seeking alternative approaches to joint care will have a better understanding of the options available.

If you are considering different ways to manage osteoarthritis, always consult a healthcare professional for personalised advice.

 

References

  1. Liao, Z.K. et al. (2025). Clinical research progress of umbilical cord blood mesenchymal stem cells in knee articular cartilage repair. Medicine.
    📄 Read More
  2. Lei, J. et al. (2025). Therapeutic efficacy of intra-articular injection of UC-MSCs in knee OA. Stem Cell Research & Therapy.
    📄 Read More

 

Osteoarthritis

Biopsychosocial Considerations of Sports Injury and Rehabilitation: A Holistic Approach to Athlete Recovery

Biopsychosocial Considerations of Sports Injury and Rehabilitation: A Holistic Approach to Athlete Recovery

Oct 14, 2024

Opus, founded by David Porter, a new perspective on sports injury rehabilitation is taking shape. Together with Professor of psychology Dave Collins and lead physiotherapist Ian Gilham, the team promotes the biopsychosocial (BPS) model—a comprehensive approach that goes beyond treating the physical injury to address the mental and social factors that impact an athlete’s recovery.

This method aims to support athletes fully, enabling them to return to peak performance with resilience.

 

Key Points:

  • Interdisciplinary Teamwork: The BPS model draws on a team of specialists, including doctors, physiotherapists, psychologists, nutritionists, and coaches. This interdisciplinary approach ensures that all aspects of an athlete’s recovery are covered, promoting a more rounded and complete rehabilitation.

  • The Biopsychosocial Model: Traditionally, rehabilitation focuses on the physical aspects of injury. However, the BPS model acknowledges that injuries affect athletes in other ways too, such as their mental health (e.g., anxiety or loss of identity) and social status (e.g., their role within the team). The model addresses these factors together for a holistic recovery.

  • Patient-Centred Care: One of the core principles of the BPS model is putting the athlete at the centre of their care. This patient-centred approach ensures that athletes are actively involved in their recovery process, which can increase motivation and help tailor the rehabilitation to their specific needs.

  • Real-Life Examples: The article shares practical case studies where the BPS model has been effectively applied. In one case, a competitive equestrian rider with a severe pelvic injury received coordinated care involving medical, psychological, and social support, which helped her overcome fears about returning to competition.

  • Rehabilitation Stages: Recovery under the BPS model follows a clear, structured path, with each phase of rehabilitation managed by the interdisciplinary team. Early stages focus on reassurance and stabilisation, while later stages incorporate goal-setting to keep the athlete motivated and engaged.

  • Social Support: The social aspect of recovery is vital for maintaining mental wellbeing. The BPS model encourages athletes to remain connected with their teams during rehabilitation, helping them feel included and supported throughout the process.

  • Goal Setting and Progress Measurement: Setting clear, achievable goals is central to the BPS model. Breaking the rehabilitation process into manageable steps allows athletes to see progress and stay motivated. Tools like the “Challenge Ladder” help measure this progress, giving athletes a clear path forward.

  • Addressing Psychological Barriers: Injuries often bring psychological challenges, such as fear of reinjury. The BPS model incorporates psychological support to address these fears early on, helping athletes regain their confidence and return to competition without hesitation.

  • Clear Roles for Specialists: With many professionals involved, clear communication is essential. The BPS model establishes well-defined roles for each specialist, doctors, physiotherapists, and coaches, ensuring consistency in care and avoiding confusion for the athlete.

  • A Look to the Future: The authors advocate for broader adoption of the BPS model across sports rehabilitation settings, noting that its holistic approach leads to more effective and complete recovery. This model is particularly beneficial in helping athletes not only return to play but come back stronger, both physically and mentally.

In this article, David Porter, Dave Collins, and Ian Gilham highlight the benefits of the biopsychosocial approach to sports injury rehabilitation.

Focusing on the athlete’s physical, mental, and social well-being, the BPS model provides a more complete path to recovery. Through interdisciplinary collaboration and patient-centred care, this approach ensures that athletes return to their sport stronger and more resilient.

This innovative approach is setting a new standard in sports medicine, helping athletes achieve the best outcomes in their recovery journey. To learn more about how the BPS model can enhance sports injury rehabilitation, read the full article here

 

 

Antibodies and the Immune System

Antibodies and the Immune System

Dec 20, 2023

Photo by Artem Podrez from Pexels

We have already looked at the role of antibody testing in the fight against COVID-19; however, there was just too much information to discuss in one post. Therefore, this post is aimed at diving into a bit more detail on antibody testing for SARS-CoV-2 and looking at misconceptions surrounding this.

When taking an antibody test, we are looking for anti-SARS-CoV-2 antibodies, which can be found in your blood as early as ten days after experiencing COVID-19 symptoms. Therefore, not only is antibody testing useful on its own, when combined with PCR testing, these detection methods minimise the likelihood of receiving a false-negative test. Moreover, antibody tests for SARS-CoV-2 are based primarily on the detection of antibodies against specific proteins. But, what does this mean? The novel coronavirus has four main structural proteins, the nucleocapsid (N), the spike (S), the membrane (M), and the envelope (E), as seen in the image below. However, antibody testing solely focuses on the detection of the S protein, consisting of S1 and S2 subunits, and the N protein, as these are the main immunogens of this virus.

The S protein of SARS-CoV-2 is located on the surface of the virus and is highly immunogenic. Each subunit of this protein plays a different role, with the S1 protein containing the receptor binding domain, a key target of neutralising antibodies. The N protein, on the other hand, plays a crucial role in the replication of viral RNA, enabling the virus to survive in our system. Its role in transcription enables the virus’s genome to be packaged into virions and also inhibits the cell cycle process of our cells. During infections, the N protein is vastly expressed and possesses high immunogenic activity.

Image taken from: https://www.invivogen.com/covid-19-related-genes

Although antibody testing is focused on detecting antibodies against either the S or N protein of SARS-CoV-2, it has been recommended that a testing method that detects antibodies against both proteins be used to gain the most accurate results. This method has been adopted across the UK, and the antibody testing at Opus is no exception to this.

COVID-19: Same-Day Fit to Fly Testing

COVID-19: Same-Day Fit to Fly Testing

Dec 20, 2023

Photo by Alex Koch from Pexels

Rapid antigen testing, also more commonly known as lateral flow testing, is a faster method of COVID-19 detection than PCR testing. Rapid antigen tests have a specificity of over 97% and have been widely adopted across the UK as a measure of controlling the COVID-19 pandemic.

These easy-to-use tests can either be done at a local test site, a healthcare provider, such as Opus Biological, or from the comfort of your own home. The tests themselves will either require a throat or a nasal swab, with our staff providing you with the instructions on which is needed. This will be done at your short medical consultation prior to the test, carried out either in person or via video consultation.

Although lateral flow tests have been largely discussed for regular COVID-19 testing in the UK, they are now being used under the Government travel guidance for those travelling to England. 

You will need to take a COVID-19 test before arriving in the UK if you either do not qualify as fully vaccinated or you have been in a country or territory on the red list in the ten days before you arrive in England. A full list of the red list countries and territories can be found here, whilst the Travel to England guidance to find out if you qualify as fully vaccinated can be found here.

This use of lateral flow tests has been termed fit to fly testing, and it does what it says on the tin, ensuring you are not carrying the COVID-19 virus before you begin your travels or return to the UK. Whether you are jetting off somewhere warm or you are simply flying with the UK, a lateral flow test offers you the freedom to do so. It is, however, important to remember that these tests must be ordered and performed through a private provider and booked in advance before your trip.

How to get your Fit to Fly test Private testing for this scheme is available at several pharmacies up and down the country. At Opus, our tests are undertaken in a UKAS accredited partner laboratory and are CE marked, ensuring you receive the most accurate results. The Fit to Fly test itself will tell you if you are infected when taking your sample, with this information being relayed to you within 24 hours of the sample reaching our labs. We also offer same day access to testing for both the COVID-19 virus and for COVID-19 antibodies, easing your mind when it comes to last minute trips.

Going abroad and want to book your Fit to Fly test at Opus? Get in touch with us now.

Health Screening: Why regular appointments are important

Health Screening: Why regular appointments are important

Dec 20, 2023

Photo by MART PRODUCTION from Pexels

Health screening checks are a great option if you are looking for a summary of your overall health. They enable us to identify any risk factors you may have for more serious health conditions that could develop later down the line. Beyond this, our health screening checks can assist you in your long term health goals, whether that be losing weight, reducing stress, or simply getting in better shape.

Our team at Opus will support you on this journey and help contribute to your healthier lifestyle. So, what exactly can our health screening checks tell you?

There are so many different health problems that may arise throughout our life, and we cannot test for all of them. However, most health problems have a similar set of underlying risk factors that can be detected. This includes a sedentary lifestyle, an unhealthy diet, high blood pressure and cholesterol, and smoking, to name a few. If you are still wondering how health screening checks and lifestyle changes can lower your risk of health problems, let’s take a look.

The phrase sedentary lifestyle often implies that your physical activity levels are very low; this may be a result of your occupation, but moving around throughout the day is detrimental to your health. The World Health Organization details that a sedentary lifestyle alone significantly increases the risk of cardiovascular diseases, diabetes, obesity, colon cancer, high blood pressure, osteoporosis, lipid disorders, depression and anxiety. Likewise, smoking represents one of the largest causes of health problems in the UK, including lung cancer, coronary heart disease, stroke, pneumonia, and bronchitis. Simply increasing your daily activity levels and cutting back on the number of cigarettes you have can significantly reduce the risk of developing these health problems in the future.

During your health screening, we will start with gaining an understanding of your daily habits, identifying any that might increase your risk of health problems later on in life, before moving on to testing. Depending on the health screening package you have selected, or that has been tailored to your needs, tests may include hydration levels, body fat percentage, urine analysis, a full blood biochemistry profile including liver and kidney function, blood glucose test for diabetes, cholesterol profile, dietary analysis, a lung function test, resting ECG, and cardiovascular risk score, amongst many others. Collectively, these will provide a great starting point for the changes that need to be made in your everyday life.

Booking a health screening can often be overwhelming, with a host of different options available online. Although we offer several different health screening and wellbeing packages available for you to book directly, our team are able to tailor the packages to your individual needs, providing you with that added peace of mind.

Get in touch today to book your health screening check and start your journey to a healthy lifestyle with Opus.