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Shoulder Pain: Rotator Cuff Repair & Surgical Options

Shoulder Pain: Rotator Cuff Repair & Surgical OptionsLiving in Florida provides gorgeous weather throughout the entire year, which allows for an active lifestyle. But with all of this healthy activity, many individuals are more prone to injury and wear and tear.

Your shoulder is a combination of bones, joints, ligaments, tendons, and muscles that provide an extensive range of motion in common everyday tasks, as well as in advanced athletic performance. Whether you’re using a walker, picking up a heavy grocery bag, or driving the ball 200 yards, an optimal range of motion is key to healthy living. However, many times shoulder pain is due to advanced arthritis or degenerative joint disease. If you have tried pain medications, alternative methods, physical therapy and are still experiencing difficulty with range-of-motion or impingements and discomfort it may be time to speak to your orthopedic surgeon about shoulder replacement surgery, also known as shoulder arthroplasty.

Bryan Hanypsiak, M.D., Board Certified Orthopedic Surgeon with Physicians Regional Medical Group, sheds light on rotator cuff tears, “Most tears of the rotator cuff occur slowly over time as the tissue wears out. They are usually found in patients over the age of 50. The most common presentation for a traumatic rotator cuff tear in my office is a shoulder dislocation in a patient over the age of 50 following a fall.”

Any force strong enough to tear tendons also damages and weakens the surrounding ligaments. Typically, a surgical procedure focuses on what is seen on an MRI, along with the evaluation of the overall shoulder stability which is essential if the individual wants to return to their normal activities. For full tears of the rotator cuff, surgery is necessary, but if the person can use their arm with some mobility, the tear may be partial, and arthroscopic repair may suffice.

Shoulder pain is multifactorial, and rotator cuff injuries result in instability, frozen shoulder, and severe discomfort. In the case of rotator cuff tears, Dr. Hanypsiak explains his protocol for treating tears based on their severity.

“Most rotator cuff tears can be treated nonoperatively. However, painful tears, and tears that interfere with shoulder function should be treated with surgical repair. This is performed arthroscopically. For larger tears, a patch can be inserted to augment the repair. For tears that cannot be repaired, a rotator cuff ‘replacement’ surgery such as superior capsular reconstruction can be performed. For patients over the age of 70 with reduced function, pain and a massive, irreparable rotator cuff tear, a special kind of shoulder replacement called a reverse ball and socket is often recommended. This shoulder replacement allows the deltoid to lift the arm without requiring the rotator cuff to function.”

Shoulder Replacement Surgery
During a traditional shoulder replacement procedure, the surgeon will remove part of the top of the humerus bone, which is located in the joint of the shoulder. The surgery consists of reshaping the shoulder joint and placing a metal stem (a few inches long) into the shaft of the humerus bone. A metal or plastic plate is then attached to the glenoid socket. These two connected devices will then take the place of the “ball and socket” in the upper shoulder area. Over time, the new joint replacement will allow the shoulder to move more freely, and it will substantially alleviate the pain that the individual was accustomed to on a daily basis. This surgery is ideal for patients with compressed rotator cuff function.

Reverse Shoulder Replacement Surgery
For individuals with a large tear, a reverse total shoulder replacement is beneficial. Because the shoulder joint is weak, the ball is fixed to the socket while the cup is attached to the upper portion of the humerus. This procedure allows the shoulder to rely on the deltoid muscle which increases stability and range of motion.

Shoulder Arthroplasty Recovery
After surgery, the initial recovery time usually takes about six weeks, but full recovery can take a few months up to a year. Many patients report feeling no pain, and also having an increased range-of-motion very soon after surgery. Your surgeon will also provide you with an exercise and stretching program, along with physical therapy for an allotted period of time.

Dr. Bryan Hanypsiak, board certified and fellowship trained in orthopedic surgery, specializes in shoulder and knee surgery, including replacements, cartilage transplants, and joint preservation procedures, hip arthroscopy, robotic-assisted knee replacements, ultrasound evaluation of acute injuries and guided injections of the hip.

Dr. Hanypsiak’s offices are located in Naples at Physicians Regional – Pine Ridge, 6101 Pine Ridge Rd and Physicians Regional – Collier Blvd, 8340 Collier Blvd. For more information or to schedule an appointment, please call 239-348-4221, or schedule online at www.PhysiciansRegionalMedicalGroup.com.

Dr. Hanypsiak, MD, FAAOS, CAQ
Sports Medicine

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