Bioinductive Implant
Florida Orthopaedic Institute is now using a new breakthrough procedure to treat patients with rotator cuff disease. The Rotation Medical Bioinductive Implant biologically helps tendons heal through the induction of new tissue growth, helping patients resume normal activities quicker than traditional treatments, while reducing the likelihood of further degeneration or re-tears.
This minimally invasive system is a new option for people suffering from rotator cuff tendon tears in the shoulder joint. Rotator cuff tears are the most common source of shoulder pain and disability, affecting more than 4 million people a year in the U.S. Many patients avoid rotator cuff surgery because they have heard about painful, lengthy postoperative rehabilitation and time away from work.
Rotation Medical Bioinductive Implant
About the size of a postage stamp, the Rotation Medical Bioinductive Implant is inserted through a small incision during a minimally invasive procedure. Bioinductive implants induce the formation of new tendinous tissue over the surface of the tendon, resulting in a thicker tendon. Depending on the stage of rotator cuff disease, the bioinductive implant provides patients a range of potential benefits, including shorter rehabilitation, faster recovery, prevention or slowing of disease progression, healing of partial-thickness tears, and decreased risk of developing a subsequent tear.
Rotator Cuff Injuries
Surrounding the shoulder joint, the rotator cuff is a group of muscles and tendons that surround, move and stabilize the shoulder joint. The rotator cuff keeps the head of the upper arm bone firmly within the shallow socket of the shoulder. Rotator cuff injuries usually cause a dull ache in the shoulders, which can worsen when sleeping on the injured side. A torn rotator cuff can make daily activities like getting dressed, sleeping or brushing your teeth painful and difficult to do. They can prevent you from doing things like work, or things that you love to do like playing sports and living an active lifestyle.
When a rotator cuff tear occurs, the tendon separates from the humeral head (the top of the upper arm bone). There are two types of rotator cuff tears:
- Partial – Where the soft tissue is damaged but the tendon is not completely torn away. Typically caused by aging, weakness, or overuse of the tendon.
- Complete – also known as a full thickness tear, when the soft tissue is completely separated from the bone. In most cases, the rotator cuff tendon tears directly off the attachment site.

Causes and Risk Factors
Rotator cuff tears are usually caused by persistent wear and tear with degeneration of the tendon. It is estimated that four million people in the United States suffer from rotator cuff disease, and approximately 25% to 50% of U.S. adults over 40 years of age have a rotator cuff tear. Rotator cuff tears occur in people who repeatedly perform overhead motions in their jobs or sports, as well as the following factors.
AGE – The risk of rotator cuff injury increases with age. Torn rotator cuffs are the more common in people ages 35 and older. More than 50 percent of people over age 60 have rotator cuff injury symptoms.
SPORTS – Repetitive arm motions, like those above the head and behind the back, increase the chance of a rotator cuff injury. Sports where athletes regularly perform such actions include golf, baseball, archery, swimming, surfing, and tennis.
WORK – Manual laborers who use repetitive overhead movements are more prone to rotator cuff injuries. Construction workers, carpenters, house painters, firefighters, and law-enforcement officials have an increased risk of this type of injury.
GENETICS – If torn rotator cuffs are common in your family, you may be at an increased risk with a predisposition for frayed or weak shoulder tendons.Overuse injuries from continually over-exerting activities are the some of the major cause of bursitis or tendinitis. Overuse injuries are commonly found in individuals who play competitive sports, but can also be related to repetitive activities such as painting or stocking shelves. The overuse activities cause friction and scraping of the rotator cuff and its nearby joints. Bursitis or tendinitis is cared for by moderating and reducing the activity, along with a rehabilitation program prescribed by a Florida Orthopaedic Shoulder specialist.

Rotator Cuff Symptoms
- Pain in the shoulder, especially when lifting or lowering the arm, or while lying on the affected shoulder.
- Often described as a dull ache deep in the shoulder.
- Disturbed sleep, particularly if you lie on the affected shoulder.
- Difficult to comb your hair or reach behind your back.
- Weakness in the affected arm, especially when lifting and rotating the arm.
- Locking of the shoulder.
- A crackling sensation when the shoulder is moved in certain positions.
- Feeling like the shoulder is “catching”.
- A feeling of instability in the shoulder.
Because traditional treatments do not address the poor quality of the underlying tendon tissue, a significant number of these tendons often develop into larger, more painful and incapacitating tears or re-tears due to continuing degeneration of the torn tendon. Bioinductive implants allow Florida Orthopaedic surgeons to intervene early and help prevent disease progression by augmenting and healing the tendon before the injury worsens.
Conventional surgery to repair rotator cuffs is effective, but repairs take a long time to heal. In the repaired area, there are a low number of cells to assist in healing, and a poor blood supply. The mechanical load on tendons is high, which can cause a repaired tendon to re-tear. Overuse injuries from continually over-exerting activities are the some of the major cause of bursitis or tendinitis. Overuse injuries are commonly found in individuals who play competitive sports, but can also be related to repetitive activities such as painting or stocking shelves. The overuse activities cause friction and scraping of the rotator cuff and its nearby joints. Bursitis or tendinitis is cared for by moderating and reducing the activity, along with a rehabilitation program prescribed by a Florida Orthopaedic Shoulder specialist.

Using Bioinductive Implants to Repair and Heal Rotator Cuff Injuries
Manufactured by Rotation Medical, bioinductive implants are suitable for most rotator cuff disease, from small partial-thickness tears to massive full-thickness tears. They are derived from bovine Achilles tendon and gradually absorbed within six months, leaving a layer of new tendon-like tissue to biologically increase the existing tendon. This treatment can be used for both previously treated and untreated patients. Introduced to the market in 2014, the technology has been used in thousands of rotator cuff procedures in the U.S.
Not all patients with painful rotator cuffs require surgery. Nonsurgical treatments, like modified activities, strengthening exercises, physical therapy and steroid injections can be used in many cases to treat the shoulder. At Florida Orthopaedic, our philosophy is to first try all appropriate nonsurgical methods to increase mobility and function. Then, and only then, do we suggest surgery.
Several surgeons at Florida Orthopaedic have undergone extensive training and have performed many bioinductive implants. For more information and to find out if a bioinductive implant procedure is right for you, call to schedule a consultation with one of our orthopedic surgeons who specialize in rotator cuff tear treatments.Overuse injuries from continually over-exerting activities are the some of the major cause of bursitis or tendinitis. Overuse injuries are commonly found in individuals who play competitive sports, but can also be related to repetitive activities such as painting or stocking shelves. The overuse activities cause friction and scraping of the rotator cuff and its nearby joints. Bursitis or tendinitis is cared for by moderating and reducing the activity, along with a rehabilitation program prescribed by a Florida Orthopaedic Shoulder specialist.
Questions & Answers
What is the Rotation Medical Bioinductive Implant?
The Rotation Medical Bioinductive Implant is a collagen-based implant about the size of a postage stamp. It is delivered arthroscopically through a small incision located over the injured rotator cuff tendon and attached with proprietary staples. The Bioinductive Implant induces the formation of new tendinous tissue over the surface of the tendon, resulting in a thicker tendon. It is the first and only implant to clinically demonstrate that it induces new tendinous tissue growth, helping tendons heal.
The Rotation Medical Bioinductive Implant can be used early in the disease before it progresses and has potential to prevent disease progression and reduce re-tear rates by addressing the underlying root cause – excessive stress and strain in the tendon.
How does the technology work?
The Rotation Medical Bioinductive Implant is highly porous. Shortly after implantation new fibrovascular tissue completely fills the porosity of the implant. The Implant is designed with unique biomechanical properties that induce this new tissue to remodel into linearly oriented, tendon-like tissue. As part of the remodeling process the implant gradually absorbs within about six months, leaving a layer of new tissue to biologically augment the existing tendon. Due to the very high purity of the implant, there has not been any observation of an adverse inflammatory response or foreign body reaction associated with the implant.
What are the benefits of the Bioinductive Implant?
Depending on the stage of rotator cuff disease, the Bioinductive Implant can provide a range of potential benefits for patients(1), including:
- Shorter rehabilitation, with decreased sling time.
- Faster recovery, with less physical therapy.
- Prevention or slowing of disease progression.
- Healing of partial-thickness tears.
- Decreased risk of developing a subsequent degenerative tear.
What are the drawbacks of traditional treatments?
Traditional approaches to treating rotator cuff injuries focus only on mechanical repair, but do not address the underlying biology of the tendon. Additional details of traditional treatments:
- Have high incidence of failures – a significant number of these tendons, after standard treatment, either degenerate further and/or re-tear.
- Many patients avoid and/or delay surgery because of painful and long rehab and surgical failures.
How common are rotator cuff injuries in the U.S.?
- Rotator cuff disease is the most common source of shoulder pain, affecting more than 4 million people annually in the U.S.
- Many people choose to forego surgery until pain is severe and range of motion is significantly impaired. However, as rotator cuff disease progresses, it can become increasingly difficult for a surgeon to repair.
Is there clinical evidence to support this new technology?
There is a growing body of evidence demonstrating the ability of the Bioinductive Implant to safely induce new tendinous tissue growth:
- Multiple studies have shown that the technology is safe and effective.
- FDA clearance was obtained in spring 2014.
- Thousands of patients have received the Rotation Medical Bioinductive Implant in the U.S.
(1) Currently there is no definitive clinical evidence to support that the implant reduces pain or gets patients back to activities more quickly. However, in some cases the implant shortened or sped up rehabilitation, which may get patients back to activities more quickly.
(2,4) Ken Yamaguchi, Konstantinos Ditsios, William D. Middleton, Charles F. Hildebolt,Leesa M. Galatz, Sharlene A. Teefey; The Demographic and Morphological Features of Rotator Cuff Disease: A Comparison of Asymptomatic and Symptomatic Shoulders. J Bone & Joint Surgery. 2006 Aug; 88(8): 1699-1704.
(3) Commissioned Market Research Report
(5) Nathan A. Mall, Miho J. Tanaka, Luke S. Choi, George Paletta, Jr.; Factors Affecting Rotator Cuff Healing. J Bone & Joint Surgery. 2014; 96:778-88.
Areas of Focus
- Shoulder
- AC Joint Injuries
- Arthroscopic Rotator Cuff Repair
- Atraumatic Shoulder Instability
- Bankart Repair
- Bicep Tendon Tear
- Bicep Tenodesis
- Bioinductive Implant
- Broken Collarbone
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Clavicle Fractures
- Dislocated Shoulder
- Fractures Of The Shoulder Blade (Scapula)
- Glenoid Labrum Tear
- Impingement Syndrome of the Shoulder
- Little League Shoulder
- Reverse Total Shoulder Replacement
- Rheumatoid Arthritis (RA) of the Shoulder
- Rotator Cuff Tears
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Injury: Pain In The Overhead Athlete
- Shoulder Replacement
- Shoulder Separations
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Subacromial Decompression
- Trapezius Strain (Muscle Strain of The Upper Back)
- Traumatic Shoulder Instability
Download the Bioinductive Implant Brochure
Christine Humienny, Bioinductive Shoulder Implant Testimonial
The following Florida Orthopaedic Institute physicians specialize in Bioinductive Implants:
Specialties
- AC Joint Injuries
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- ACL Injuries
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion Surgery
- Anterior Cervical Corpectomy & Discectomy
- Arthritis & Adult Reconstruction Surgery
- Arthroscopic Articular Cartilage Repair
- Arthroscopic Chondroplasty
- Arthroscopic Debridement of the Elbow
- Arthroscopic Rotator Cuff Repair
- Articular Cartilage Restoration
- Artificial Disk Replacement (ADR)
- Aspiration of the Olecranon Bursa
- Atraumatic Shoulder Instability
- Avascular Necrosis (Osteonecrosis)
- Bankart Repair
- Basal Joint Surgery
- Bicep Tendon Tear
- Bicep Tenodesis
- Bioinductive Implant
- Bone Cement Injection
- Bone Growth Stimulation
- Broken Collarbone
- Bunions
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Carpal Tunnel Syndrome
- Charcot Joint
- Chiropractic
- Clavicle Fractures
- Colles’ Fractures (Broken Wrist)
- Community Outreach
- Cubital Tunnel Syndrome
- De Quervain's Tenosynovitis
- Degenerative Disk Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discectomy
- Discitis Treatment & Information
- Dislocated Shoulder
- Dupuytren’s Disease
- Elbow
- Elbow Bursitis
- Elbow Injuries in Throwing Athletes
- Epidural Injections for Spinal Pain
- Finger Dislocation
- Flexor Tendonitis
- Foot, Ankle & Lower Leg
- Foraminotomy
- Fractured Fingers
- Fractures Of The Shoulder Blade (Scapula)
- Fractures Of The Tibial Spine
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- General Orthopedics
- Glenoid Labrum Tear
- Golfer's Elbow
- Groin Strains and Pulls
- Growth Plate Injuries Of The Elbow
- Hallux Rigidus Surgery - Cheilectomy
- Hammer Toe
- Hamstring Injuries
- Hand & Finger Replantation
- Hand & Wrist
- Hand Nerve Decompression
- Hand Skin Grafts
- Hand, Wrist, Elbow & Shoulder
- Heat Injury/Heat Prostration
- High Ankle Sprain (Syndesmosis Ligament Injury)
- Hip & Thigh
- Hip Arthroscopy
- Hip Dislocation
- Hip Flexor Strains
- Hip Fractures
- Hip Hemiarthroplasty
- Hip Impingement Labral Tears
- Hip Muscle Strains
- Hip Pointers and Trochanteric Bursitis
- Hyperextension Injury of the Elbow
- Iliopsoas Tenotomy
- Iliotibial Band Syndrome
- Impingement Syndrome of the Shoulder
- Interlaminar Implants
- Interlaminar Lumbar Instrumental Fusion: ILIF
- Interventional Pain Management
- Interventional Spine
- Intraarticular Calcaneal Fracture
- Knee & Leg
- Kyphoplasty (Balloon Vertebroplasty)
- Kyphosis
- Labral Tears Of The Hip (Acetabular Labrum Tears)
- Laminectomy: Decompression Surgery
- Lateral Collateral Ligament (LCL) Injuries
- Lisfranc Injuries
- Little League Shoulder
- LITTLE LEAGUER'S ELBOW (MEDIAL APOPHYSITIS)
- Lumbar Epidural Steroid Injection
- Lumbar Interbody Fusion (IBF)
- MACI
- Mallet, Hammer & Claw Toes
- Medial Collateral Ligament Injuries
- Meniscus Tears
- Metatarsalgia
- Minimally Invasive Spine Surgery
- Morton’s Neuroma
- Muscle Spasms
- Nerve Pain
- Neuromas (Foot)
- Neurosurgery
- Olecranon Stress Fractures
- Orthopaedic Total Wellness
- Orthopedic Physician Or A Podiatrist?
- Orthopedic Trauma
- Osteoarthritis of the Hip
- Osteoporosis
- Outpatient Spine Surgery
- Partial Knee Replacement
- Patellar Fracture
- Pelvic Ring Fractures
- Peripheral Nerve Surgery (Hand) Revision
- Pinched Nerve
- Piriformis Syndrome
- Piriformis Syndrome
- Plantar Fasciitis
- Podiatry
- Primary Care Sports Medicine
- Quadriceps Tendon Tear
- Radial Tunnel Syndrome (Entrapment of the Radial Nerve)
- Revascularization of the Hand
- Reverse Total Shoulder Replacement
- Rheumatoid Arthritis (RA) of the Shoulder
- Rheumatoid Arthritis Of The Hand
- Robotics
- Rotator Cuff Tears
- Runner's Knee
- Sacroiliac Joint Pain
- Sciatica
- Scoliosis
- Senior Strong
- Shin Splints
- Shoulder
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Injury: Pain In The Overhead Athlete
- Shoulder Replacement
- Shoulder Separations
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Spinal Fusion
- Spine
- Spondylolisthesis and Spondylolysis
- Sports Foot Injuries
- Sports Hernias (Athletic Pubalgia)
- Sports Medicine
- Sports Wrist and Hand Injuries
- Sprained Ankle
- Sprained Wrist Symptoms and Treatment
- Subacromial Decompression
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Tennis Elbow
- Thigh Fractures
- Thigh Muscle Strains
- Thumb Ulnar Collateral Ligament Injuries
- Total Ankle Replacement
- Total Hip Arthroplasty
- Total Hip Replacement - Anterior Approach
- Total Knee Replacement Surgery
- Trapezius Strain (Muscle Strain of The Upper Back)
- Traumatic Shoulder Instability
- Triceps Tendonitis
- Trigger Finger
- Turf Toe
- UCL (Ulnar Collateral Ligament) Injuries
- Ulnar Neuritis
- Valgus Extension Overload
- Vertebroplasty
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Whiplash and Whiplash Associated Disorder (WAD)
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Tendonitis