A research study by Dr. Ward S. Oakley Jr., orthopaedic surgeon, and Connie Tighe with Pinehurst Surgical, entitled "The Prevalence of a Diabetic Condition and Adhesive Capsulitis of the Shoulder" was published in the Southern Medical Journal in June 2008.

According to the Sandhills Multi-Institutional Review Board (SMIRB), this is one of only a few clinical research studies performed by a local physician that it has approved and that came to publication.

This clinical research study was conducted at Pinehurst Surgical on 100 consecutive patients with adhesive capsulitis, a condition of the shoulder that causes significant stiffness and pain. Adhesive capsulitis occurs more frequently in women than men, and more commonly during their mid-40s to mid-60s.

There is no known cause for this condition. Its symptoms of pain and stiffness are frequently seen with other common conditions of the shoulder such as arthritis and rotator cuff tear, a news release said.

In this clinical study, patients who were not known to be diabetic were specifically tested for diabetes. The study results showed that the total prevalence (frequency) of a diabetic condition in patients with adhesive capsulitis was 71.5 percent. This finding was a significant change from the accepted belief that the frequency was only about 20 percent, the release said.

This study was the first to address specifically the frequency of diabetes in patients with this shoulder condition by testing for both diabetes and pre-diabetes. Patients with pre-diabetes have a high likelihood of progressing to diabetes, which would then require medical treatment -- specifically the need for diabetic pills or insulin injections.

The good news for patients with this condition is that it is usually self-limiting, getting better and resolving on its own over six to 12 months. Patients who have more pain and stiffness than they care to bear frequently respond rapidly to a steroid injection and physical therapy. Only rarely do patients need to have surgical manipulation (breaking adhesions loose) or surgical arthroscopic debridement of the excessive scar tissue that can build up.

Oakley and Tighe have recently been approved by the SMIRB to conduct their third shoulder study. This study is entitled "Treatment of Partial/Interstitial Rotator Cuff Tears with Buffered Platelet-Rich Plasma."

Participants in the study will include patients who have a diagnosis of a small (partial) tear of their rotator cuff and have failed to respond to the usual treatments of medicines, therapy and injections, and are considering surgery because of the persistent pain and weakness.

A tear of the rotator cuff of the shoulder can result from an injury, from repetitive overhead abuse, and from a simple degenerative process over time. The classic symptoms of a rotator cuff tear are pain in the upper arm, most frequently at night, loss of motion at the extremes such as reaching overhead and/or the middle and upper back, and loss of strength of use of the arm. Once there is a complete tear with a gap in the cuff and it will not heal by itself, surgery is required.

Volunteer patients who elect to participant in the study will receive an alternative treatment that consists of a series of one or two injections into their rotator cuff tear of a concentration of their own platelets.

Platelets are one of the smaller cells in the blood stream that contain various growth factors. These growth factors are known to be essential and instrumental in starting a healing process of any damaged tissue.

Each patient will have to use a sling for a period of one week to protect the tear site of the rotator cuff. Restricted and limited use of the shoulder will be strongly encouraged for six weeks. Participants will be evaluated at specific intervals during the study and followed for a year.

It is hoped that this treatment alternative will provide early relief of the pain from a partial rotator cuff tear and achieve healing of that tear, thus avoiding the need for surgery, the news release said. At this time, this treatment is not thought to be reasonable for complete tears of the rotator cuff where there is displacement or gap in the cuff tissue.

The MRI (magnetic resonance imaging) is the best tool available to determine the presence and severity of a tear of a shoulder's rotator cuff, according to the news release.

Oakley has provided orthopaedic care at Pinehurst Surgical since 1994. He received his medical degree from the University Of Tennessee Center for Health Science in Memphis and his MBA, Physician Executive MBA Program, University of Tennessee in 2000.

Tighe joined Pinehurst Surgical in 1989. She received her bachelor's and master's degrees in nursing from the University of North Carolina at Charlotte.