NanoATi · Patient selection
Which rotator-cuff problems may suit NanoATi?
NanoATi is considered only after the involved shoulder tendon, useful continuity, strength and previous rehabilitation have been defined.
Reviewed byProfessor Paul Lee MBBch, FRCS (Tr & Orth), PhDCartilage and joint preservation expertiseQuick answer
Selected rotator-cuff tendinopathy and partial-thickness damage may fit when useful continuity remains and first-line shoulder rehabilitation has been addressed. Complete tear, detachment or marked retraction is a different mechanical problem.
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Structural starting point
The rotator cuff must still transmit useful force
NanoATi is principally considered for selected rotator-cuff tendinopathy, intrasubstance degeneration and partial-thickness damage where useful continuity remains. It cannot reattach a complete tear or a tendon that has pulled away from bone.
The same pain location can reflect tendon overload, a partial tear, referred pain, joint disease or nerve irritation. Diagnosis has to be more precise than “sore tendon”.
- Persistent symptoms after a well-run first-line rehabilitation programme
- A defined rotator-cuff target on examination and imaging
- Useful tendon continuity and function remain
- A realistic loading plan can be completed after treatment
Assessment
Imaging, strength and load history must tell the same story
Ultrasound can show tendon structure dynamically and guide precise delivery. MRI may be useful for deeper anatomy, tear extent and associated joint disease. Neither scan replaces examination or a clear account of what load provokes symptoms.
Strength loss, night pain, traumatic onset, change in reaching or lifting and previous rehabilitation all alter the decision. Other tendons can be assessed, but the NanoATi pathway is led by the demands of the rotator cuff.
Reasons to change route
Some tendon findings need surgical assessment
Complete rupture, marked retraction, tendon detachment from bone, substantial functional weakness or an acute injury where delay matters can point towards repair. The precise threshold depends on the tendon, patient and functional goal.
NanoATi also should not bypass a well-designed exercise programme. It is generally considered after diagnosis and first-line load management have been addressed.
NanoATi suitability questions
Can NanoATi treat a complete tendon rupture?
It cannot reattach a completely ruptured or detached tendon. Complete failure, retraction or major weakness needs an appropriate surgical assessment.
Do I need to try physiotherapy first?
A well-run progressive loading programme is first-line treatment for many tendon problems. NanoATi is normally considered when the diagnosis is clear and symptoms persist despite appropriate rehabilitation.
Which tendons may be assessed?
The main focus is the rotator cuff, particularly selected supraspinatus tendinopathy and partial-thickness damage. Other tendons may be assessed individually where the same continuity and rehabilitation principles apply.
Is ultrasound enough?
Ultrasound is valuable for many tendons and for guided delivery. MRI may still be needed when anatomy is deep, the tear is complex or associated joint disease must be assessed.
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 rotator-cuff problem before choosing treatment
Professor Lee can combine shoulder examination, ultrasound and MRI where required to distinguish tendinopathy, partial-thickness damage and mechanical failure.