RegenRepair™ · Tendon pathway
NanoATi
Autologous Tendon Injection
A shoulder-led Seed, Soil, Signal pathway for selected rotator-cuff tendinopathy and partial-thickness damage, combined with image guidance and progressive rehabilitation.
Reviewed byProfessor Paul Lee MBBch, FRCS (Tr & Orth), PhDCartilage and joint preservation expertiseQuick answer
NanoATi is centred on viable rotator-cuff tendon. It may suit selected tendinopathy and partial-thickness damage where useful continuity remains. Other tendons can be assessed, but a complete or retracted rupture is a different structural problem.
NanoATi—also written Nano ATi—means a non-arthroscopic, needle-delivered, one-stage autologous tendon injection technique.
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Identify the structural problem
Rotator-cuff damage is not one diagnosis
Shoulder pain can reflect overload, tendinopathy, partial-thickness rotator-cuff damage or complete failure. The pathway depends on which pattern is present.
RegenRepair for tendon
A tendon-specific Seed for the rotator cuff
The Seed may come from a small direct tendon sample, retaining tissue-specific tenocytes, or from a hair-follicle-bearing dermal sample as an accessible fibroblast-rich alternative. Type-I collagen provides the Soil and platelet-rich fibrin the autologous Signal.
A staged pathway
Diagnose precisely, deliver precisely, reload deliberately
Tendon capacity
Recovery is measured by load, not the calendar alone
The rotator cuff must tolerate reaching, lifting and controlling the arm away from the body. Rehabilitation therefore progresses towards shoulder-specific range and load, using symptoms, strength and function to guide each step.
The goal is not permanent rest. It is a controlled return to useful force.
Questions assessment answers
- Is the tendon continuous or mechanically failed?
- Where is the abnormal tissue on ultrasound or MRI?
- What load currently provokes symptoms?
- What strength and task must the tendon regain?
When injection is not enough
Complete rupture, marked retraction, tendon detachment from bone, major weakness or another structural lesion may need surgical reconstruction. A biological injection cannot substitute for reattaching tissue that is no longer connected.
Explore treatment optionsRegenRepair™ · Seed, Soil, Signal
Choose the tissue, then understand the pathway
The biological design is shared. The target, delivery plan and rehabilitation change with the structure being treated.
Cartilage damage
NanoACi
A one-stage, image-guided cartilage regeneration technique built around cartilage micrografts, collagen soil and a patient-derived signal.
Explore NanoACi
Stable meniscus damage
NanoAMi
A non-surgical pathway using autologous fibroblast-rich micrografts for suitable stable partial-thickness tears, intrasubstance damage and wear.
Explore NanoAMi
Rotator cuff tendon damage
Current pageNanoATi
A shoulder-led tendon pathway using autologous tenocyte or fibroblast-rich micrografts, image-guided targeting and rotator-cuff rehabilitation.
Explore NanoATi
Selected partial ACL damage
NanoALi
An ACL-led non-surgical ligament pathway for selected partial injuries where useful fibres and knee stability remain, with MCL and ankle routes assessed separately.
Explore NanoALi
NanoATi questions
What is NanoATi?
NanoATi is the tendon-specific application of Professor Paul Lee's RegenRepair Seed, Soil, Signal framework. Its Seed may be taken directly from tendon to retain tenocytes, or from a hair-follicle-bearing dermal sample as a fibroblast-rich alternative, then combined with a supporting scaffold, precise image-guided delivery and progressive loading.
What is the Seed in NanoATi?
The Seed is prepared on the day from either a small direct tendon sample, retaining tissue-specific tenocytes, or a hair-follicle-bearing dermal sample as a less invasive fibroblast-rich source. Professor Lee selects the donor route for the individual tendon.
Which tendon problems may be considered?
The principal focus is selected rotator-cuff tendinopathy, intrasubstance degeneration and partial-thickness damage where viable continuity remains. The tendon involved, tear depth, shoulder strength and mechanical demand all affect suitability.
Can NanoATi repair a completely ruptured tendon?
It cannot reattach a tendon that has completely ruptured or pulled away from bone. Complete rupture, marked retraction or major functional weakness may need surgical repair. NanoATi is considered only after the structural problem has been accurately defined.
Why is ultrasound guidance important?
Tendons are compact, layered structures and abnormal tissue can sit beside healthy fibres. Ultrasound guidance helps Professor Lee identify the target and place treatment precisely while avoiding nearby nerves, vessels and intact tendon where possible.
Why does tendon rehabilitation involve loading?
Tendons adapt to mechanical demand. Too much load too early can aggravate the tissue, while too little load can leave it underprepared. Rehabilitation therefore progresses from protection through controlled strength to task- or sport-specific demand.
Still have more specific concerns?
Free Discovery CallOptions that our doctors may discuss include NanoACi, ChondroFiller, Mytocel MSK, joint replacement, established conservative care or surgery, depending on examination and imaging.
Define the tendon problem before choosing treatment
Clinical examination, ultrasound and MRI where needed establish whether the tendon is overloaded, degenerative, partially torn or mechanically ruptured.