FAQ

Non-Surgical Shoulder Treatment FAQ

“Surgery is the only way.” “It's just your age.” “Non-surgical is just a stopgap.”
Dr. Lee addresses the misconceptions.

Non-Surgical Treatment — General

Won't non-surgical treatment eventually lead to surgery?+
Not necessarily. The key is accurate diagnosis and correct candidacy judgment. When the latest techniques are applied to appropriate candidates, outcomes equivalent to or better than surgery are achievable. However, for extensively progressed full-thickness tears, Bankart lesions, and similar conditions, surgery may indeed be more appropriate.
I've had repeated injections but nothing worked — why?+
Not all injections are the same. Failing steroid, PDRN, DNA, or collagen injections (1st–2nd generation) does not mean non-surgical care is impossible. Many patients have never received 3rd–4th generation treatments such as calcific aspiration, plication suture, bone marrow stem cell therapy, or the patented ligament regeneration injection.
Am I too old for non-surgical treatment?+
Age alone is not a reason for surgery. Elderly patients often face greater risks from general anesthesia and surgical recovery — making non-surgical approaches more appropriate. 'Nothing can be done at your age' is not a diagnosis. Recovery to daily function is achievable even in patients in their 70s with appropriate non-surgical treatment.
I was told surgery is the only option. Is that true?+
The standard for that judgment should be examined first. Cases suitable for non-surgical resolution are more numerous than commonly assumed. However, full-thickness tears with muscle atrophy/fatty degeneration, acute traumatic full-thickness tears in young patients, recurrent shoulder dislocation (Bankart lesion), and failures after comprehensive non-surgical attempts are cases where surgery produces better outcomes. The first question to ask: 'Have I actually tried all the latest non-surgical options?'
What is the difference between generations of non-surgical treatment?+
1st gen: steroids/NSAIDs (pain suppression). 2nd gen: PDRN/hyaluronic acid/DNA injection (cell activation). 3rd gen: calcific aspiration/plication suture/bone marrow stem cell (structural treatment). 4th gen: patented ligament regeneration injection/collagen patch Regeneten (regeneration promotion + structural restoration). Higher generations represent treatments closer to fundamental healing.

Calcific Tendinitis

What is calcific tendinitis?+
Calcium crystal deposits in the rotator cuff (shoulder tendon) causing severe pain. Common in women aged 40–50, visible as white masses on X-ray. Characterized by severe night pain. Pain intensity and treatment vary by phase (formative, resting, resorptive).
I had multiple shockwave sessions but the calcium is still there.+
Shockwave only stimulates hardened calcium without actually removing it. It is particularly limited for hardened formative/resting-phase calcium. Platinum's 3rd-gen crushing aspiration physically crushes and aspirates the calcium — achieving complete single-session removal even for calcium that does not respond to shockwave.
I was told the calcium is too hard to remove — is that true?+
That is a method problem. 1st–2nd generation lavage and barbotage are only effective for soft calcium. However, the patented 3rd-gen crushing aspiration uses a specialized instrument to physically crush the calcium — making even chalk-type hard calcium removable. Think of it like a blender that grinds and then suctions.
How long does the calcific aspiration procedure take?+
The procedure itself takes approximately 30–60 minutes. Performed under local anesthesia with ultrasound guidance — no general anesthesia required. Same-day discharge, no hospitalization needed.
Will the calcium come back after removal?+
Recurrence at the same site after crushing aspiration is very rare. However, if accompanying tendon damage remains, combining ligament regeneration injection or plication suture for tendon healing is important to maintain long-term results.

Rotator Cuff Tears

What percentage of rotator cuff tear requires surgery?+
The location and pattern of the tear matter more than the percentage. Even with the same 50% tear, treatment direction differs entirely depending on whether it is articular-side or bursal-side, and whether the tendon attachment is involved. Muscle atrophy and fatty degeneration are the core criteria for surgical judgment.
Pain returns whenever I'm active even after injections.+
Pain relief does not mean treatment is complete. Resuming activity with remaining structural tendon damage leads to recurrence. Pain reduction is only the beginning — fundamental tendon recovery (suture/regeneration) must occur. Plication suture or bone marrow stem cell therapy may be required for structural treatment.
Does a full-thickness rotator cuff tear always need surgery?+
Not all full-thickness tears require surgery. Small-to-medium full-thickness tears without muscle atrophy or fatty degeneration, and tears in elderly patients with low activity levels, can often achieve good results with non-surgical treatment. However, large/massive full-thickness tears with muscle atrophy, and acute traumatic full-thickness tears in young patients, are better served by surgery.
My shoulder is too stiff to raise my arm. Can non-surgical treatment help?+
A stiff shoulder (adhesive capsulitis/frozen shoulder) and rotator cuff tears are different conditions. If adhesive capsulitis is present, capsular adhesions must be addressed first, followed by ligament treatment. Do not conclude 'can't raise arm because of stiffness' without precise ultrasound/MRI diagnosis. Treatable causes are often found.

Ligament Regen Injection & Stem Cell

How is the ligament regeneration injection different from prolotherapy or PRP?+
Conventional prolotherapy uses glucose stimulation to induce inflammation and fibrosis. PRP uses autologous growth factors. Platinum's 4th-gen ligament regeneration injection goes further by combining micro-current stimulation + bone marrow induction + patented composite components (injectable composition for ligament regeneration, Patent No. 10-2855611) — promoting collagen synthesis from multiple angles simultaneously, unlike single-ingredient injections.
How many injection sessions are needed for effect?+
Depends on individual condition, but typically begins with 3–5 sessions at 2–4 week intervals. Tendon recovery is confirmed by ultrasound at each visit to adjust the number of sessions. Unlike simple analgesic injections, structural recovery is the goal — continuing treatment until sufficient ligament regeneration occurs is important even after pain subsides.
Who is a good candidate for bone marrow stem cell therapy?+
Patients with partial rotator cuff tears where 1st–2nd generation treatments (injections, shockwave) have repeatedly failed, patients with moderate-or-less tears wishing to avoid surgery, and elderly patients with high surgical risk are good candidates. The patient's own bone marrow stem cells are activated — no foreign body reaction.
What is the collagen patch (Regeneten)?+
A bioabsorbable collagen sheet derived from porcine small intestinal submucosa, placed over the torn ligament surface to support regeneration. Combined with plication suture, the tendon is fixed to bone while the collagen scaffold accelerates tissue regeneration. Uses FDA and CE-approved material, naturally replaced by autologous tissue as it absorbs.

Procedures & Appointments

What tests are done at the first visit?+
A baseline X-ray is taken, followed by ultrasound examination to assess tendon condition in real time. MRI may be additionally recommended as needed. Bringing MRI images or reports from another clinic is helpful.
How long is the recovery period after procedures?+
Varies by procedure type. Ligament regeneration injection: return to daily activities same day. Calcific aspiration: mild soreness for 2–3 days, normal activity within 1–2 weeks. Plication suture: arm sling for 2–4 weeks, then rehabilitation exercises. Bone marrow stimulation: mild discomfort at procedure site for 1–2 days.
Can I have a same-day appointment and procedure?+
Depending on diagnosis results, same-day procedures are possible in some cases. Calling in advance (02-516-3570) or inquiring via KakaoTalk before booking minimizes waiting time.
Can I drive after the procedure?+
If brachial plexus block (BPB) anesthesia is used, driving is not possible on the day of the procedure while anesthesia remains in effect. Public transportation or a companion is recommended for same-day discharge. For simple injection procedures without anesthesia (such as ligament regeneration injection), driving is generally possible the same day.

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