Wednesday, October 21, 2015

Failed rotator cuff surgery in a 70-year old - the smooth and move procedure

Surgeons are eager to attempt to repair rotator cuff tears. While acute tears in younger shoulders have a good chance of healing, chronic tears in older individuals often fail to heal. We had the pleasure of meeting an active 70 year old golfer who in spite of two recent rotator cuff repair attempts over the past two years has a painful crepitant shoulder. A recent MRI is shown below.

Yesterday we performed a 'smooth and move' procedure, finding no supraspinatus, but a good subscapularis and infraspinatus.

We removed a 'ton' of suture and suture anchors that were not in contact with cuff tendon and loose in the joint.

One day after surgery she is actively raising her arm with more range of motion and comfort than before surgery. We doubt that attempting a 'superior capsular reconstruction', 'marginal convergence', or a 'patch graft' would have given her the same rapid recovery and prompt return to golf (her passion).

Degenerative cuff tears in older individuals remind us of Robert Frosts poem, Mending Wall.


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