New surgery may fix tough-to-treat rotator cuff tears

A new surgical procedure can help people with shoulder injuries once considered beyond repair, a small new study suggests.

Out of 100 patients who had the surgery in the study, all 26 of those who had played sports before the surgery were able to play sports again afterwards. Thirty-two patients who had jobs lifting heavy workloads were able to return completely to work. Another two -- a farmer and a manual worker -- were also able to return to work, but with reduced hours and reduced workloads.

The procedure is called arthroscopic superior capsule reconstruction (SCR) surgery. It was developed by Japanese surgeons to fix rotator cuff injuries once considered irreparable.

The rotator cuff is a group of muscles, tendons and ligaments that attach your arm to your shoulder. The rotator cuff helps you lift and rotate your arm, according to the American Academy of Orthopaedic Surgeons. Over time or with an injury, the rotator cuff can develop partial or complete tears.

"Around 30 percent of medium to large tears, and more than 80 percent of massive tears are irreparable in my patients," said study author Dr. Teruhisa Mihata. He is chief of shoulder and elbow surgery and sports medicine at Osaka Medical College in Japan.

In the past, Mihata said, if the two ends of the tear could no longer meet together, a rotator cuff injury was considered permanent.

But SCR surgery grafts a soft tissue "patch" from a cadaver that's placed over the top of the shoulder joint to substitute for the missing tendons, explained Dr. Evan Karas, who wasn't involved in the study, but who has been performing this surgery for about a year. In standard rotator cuff surgery, the goal is to repair the person's own tendons, he explained.

The average age of the study patients was 67, ranging in age from 43 to 82. The average follow-up time was four years.

Ninety-five out of 102 shoulders repaired didn't have additional problems, such as a re-tear in the rotator cuff. Pain and range-of-motion improved after surgery, according to Mihata.

Some of the sports that people were able to go back to included: golf, tennis, swimming, baseball, martial arts, yoga, skiing and mountain climbing.

"SCR is the surgical technique to restore shoulder stability and improve shoulder function with pain relief, without repairing the torn rotator cuff tendons," Mihata said.

Karas agreed that the surgery seems to be successful.

"There are studies now showing good-to-excellent two-year clinical results from SCR surgery. Longer-term studies are now being conducted to prove that the results are durable over time," he said.

This surgery gives patients an option they didn't have before, Karas added.

"I see many patients with chronic rotator cuff tears who have been told by other doctors that there is nothing else that can be done for their shoulder. This leaves them with the option of living with significant pain and disability," Karas said.

    HealthDay

New surgery may fix tough-to-treat rotator cuff tears

A new surgical procedure can help people with shoulder injuries once considered beyond repair, a small new study suggests. Out of 100 patients who had the surgery in the study, all 26 of those who had played sports before the surgery were able to play sports again afterwards. Thirty-two patients who had jobs lifting heavy workloads were able to return completely to work. Another two -- a farmer and a manual worker -- were also able to return to work, but with reduced hours and reduced workloads. The procedure is called arthroscopic superior capsule reconstruction (SCR) surgery. It was developed by Japanese surgeons to fix rotator cuff injuries once considered irreparable. The rotator cuff is a group of muscles, tendons and ligaments that attach your arm to your shoulder. The rotator cuff helps you lift and rotate your arm, according to the American Academy of Orthopaedic Surgeons. Over time or with an injury, the rotator cuff can develop partial or complete tears. Around 30 percent of medium to large tears, and more than 80 percent of massive tears are irreparable in my patients, said study author Dr. Teruhisa Mihata. He is chief of shoulder and elbow surgery and sports medicine at Osaka Medical College in Japan. In the past, Mihata said, if the two ends of the tear could no longer meet together, a rotator cuff injury was considered permanent. But SCR surgery grafts a soft tissue patch from a cadaver thats placed over the top of the shoulder joint to substitute for the missing tendons, explained Dr. Evan Karas, who wasnt involved in the study, but who has been performing this surgery for about a year. In standard rotator cuff surgery, the goal is to repair the persons own tendons, he explained. The average age of the study patients was 67, ranging in age from 43 to 82. The average follow-up time was four years. Ninety-five out of 102 shoulders repaired didnt have additional problems, such as a re-tear in the rotator cuff. Pain and range-of-motion improved after surgery, according to Mihata. Some of the sports that people were able to go back to included: golf, tennis, swimming, baseball, martial arts, yoga, skiing and mountain climbing. SCR is the surgical technique to restore shoulder stability and improve shoulder function with pain relief, without repairing the torn rotator cuff tendons, Mihata said. Karas agreed that the surgery seems to be successful. There are studies now showing good-to-excellent two-year clinical results from SCR surgery. Longer-term studies are now being conducted to prove that the results are durable over time, he said. This surgery gives patients an option they didnt have before, Karas added. I see many patients with chronic rotator cuff tears who have been told by other doctors that there is nothing else that can be done for their shoulder. This leaves them with the option of living with significant pain and disability, Karas said. HealthDay