Regenexx™ SD Versus Exercise Therapy for Rotator Cuff Tears

Prospective, randomized, controlled to include 25 subjects treated with Regenexx SD and 25
subjects treated with Exercise Therapy alone.

Subjects will have a non-retracted supraspinatus tendon tear comprising at least one half the
tendon thickness in the anterior-posterior and/or superior-inferior planes as evidenced with
positive diagnostic imaging such as arthrogram, ultrasound and/or MR.

Subjects will be enrolled within 60 days prior to Regenexx-SD injection or initiation of
exercise therapy and take part in follow-up visits for two years following treatment. A
preoperative visit will occur at the time of enrollment; follow-up visits will occur at the
clinical site at 6 weeks, 3 months, 6 months, 12 months, and 24 months post injection. Target
enrollment is 50 subjects, to include 25 subjects treated with Regenexx SD and 25 subjects
treated with exercise therapy alone.

The primary endpoint analysis will be conducted once all subjects reach the 3 month endpoint.
At that point, subjects enrolled in the Exercise Therapy group will be given the option of
crossing over to the Regenexx SD treatment groups. Subjects will continue to be followed
through the 2 year endpoint with data analysis performed at the 1 year and 2 year time
points.

Subjects will complete the study following the 2 year follow-up visit.

Inclusion Criteria:

- Physical examination consistent with Rotator Cuff tear

- Unremitting pain in the affected shoulder for at least 3 months

- Significant functional disability related to pain, lack of strength, or other shoulder
symptoms

- Positive diagnostic imaging, which may include arthrogram, ultrasound and/or MR, on
the affected shoulder indicating a non-retracted supraspinatus tendon tear comprising
at least one half the tendon thickness in the anterior-posterior and/or
superior-inferior planes

- Reasonable movement of the non-treated arm, defined as a shoulder elevation of equal
or more than 90°, and able to perform (post-injection) exercises

- Is independent, ambulatory, and can comply with all post-operative evaluations and
visits

Exclusion Criteria:

- A massive rotator cuff tear as demonstrated by Grade 3 or less muscle strength on
testing internal and external rotation of the affected shoulder

- Previous surgery to the affected shoulder

- Concomitant tears of multiple rotator cuff or biceps tendons

- Grade 2 or greater SLAP tear

- Type 3 acromion

- Significant bone spur in subacromial space

- Inflammatory or auto-immune based joint diseases or other upper extremity pathology
(e.g., rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis,
polymyalgia, polymyositis, gout pseudogout)

- Quinolone or Statin induced myopathy/ tendinopathy

- Kellgren-Lawrence grade 2 or greater glenohumeral osteoarthritis

- Adhesive capsulitis (mild or severe)

- Symptomatic cervical spine pathology (e.g. radicular cervical pain)

- Severe neurogenic inflammation of the cutaneous nerves about the shoulder

- Shoulder instability requiring surgical stabilization

- Contraindications for MRI

- Tested positive or has been treated for a malignancy in the past or is suspected of
having a malignancy or is currently undergoing radiation or chemotherapy treatment for
a malignancy anywhere in the body, whether adjacent to or distant from the proposed
injection site

- Condition represents a worker's compensation case

- Currently involved in a health-related litigation procedure

- Is pregnant

- Bleeding disorders

- Currently taking anticoagulant or immunosuppressive medication

- Use of chronic opioid