Rotator cuff injuries don't just happen to Major League Baseball players. They send 5 million people to the doctor every year. The risk of injury increases as we age.

Now, there's a new procedure that aims to relieve pain and restore movement by changing the way the shoulder works.

A motorcycle accident left Jim Smith with a shoulder injury so painful he couldn't ride or even raise his right arm.

“I was down to practically doing nothing. I couldn't even trim bushes in the yard because I didn't have any control of my right arm,” says Jim.

A traditional shoulder replacement failed. Then, Dr. Bryan Wall, an orthopedic surgeon at the Core Institute of Phoenix, AZ, suggested something new - reverse shoulder replacement. The normal ball and socket joint is replaced with implants that reverse the anatomy of the shoulder.

“The reverse shoulder replacement, what it does is it allows us to not only replace the joint that has become arthritic, but it puts the shoulder in a better mechanical position and changes the mechanics of the shoulder to allow people to elevate their arm,” says Dr. Wall.

The surgery works best for older patients who have chronic shoulder pain, longstanding rotator cuff tears and arthritis. It doesn't work for everyone - there's a risk of patients dislocating the shoulder joint after surgery or loosening it.

“The best thing is whatever I do during the day, no matter what I do, I don't have any pain in my right arm,” says Jim.

The surgery fixed Jim's shoulder so he could get back to doing his own fixing…

“I've worked pretty hard all my life. Now it's time to play!” he says.

Now Jim is hitting the road to a pain-free and active retirement.

The surgery usually means a two-day hospital stay and a four-to-six week recovery, plus some therapy.

Dr. Wall says younger patients are generally not good candidates for the procedure because they tend to put extreme stress on the shoulder joint.

RESEARCH SUMMARY

TOPIC: REVERSE SHOULDER REPAIR
REPORT: MB #3048
BACKGROUND: One study suggests 34 percent of the population has suffered a rotator cuff tear.
The risk of the injury increases with age and is most often caused by degeneration of the tendon rather than sudden injury or trauma, according to the American Academy of Orthopaedic Surgeons(AAOS). The rotator cuff is a group of four muscles that surround the ball of the shoulder joint. The cuff functions to help the arm rotate, elevate and stabilize. The symptoms of a rotator cuff include pain, loss of motion and weakness.
One factor that contributes to the gradual degeneration of the rotator cuff is reduced blood supply, which happens as the body ages. Since less blood reaches the tendon, the body's ability to repair it decreases. Another cause of age-related rotator cuff degeneration are bone spurs, which rub on the rotator cuff and gradually weaken it. These two factors can combine to lead to a tear. Surgeons typically remove bone spurs during surgery to repair a rotator cuff tear.
TREATMENT: The AAOS says treatments besides surgery provide relief for about 50 percent of patients with torn rotator cuffs. Nonsurgical treatment typically means avoiding activities that worsen pain from the tear. Patients who suffer tears that cause severe weakness are caused by acute trauma and/or are very large may be considered for surgery, in which doctors aim to re-attach the tendon to the ball of the shoulder joint. Risks of surgery, which the AAOS estimates to happen in approximately 10 percent of cases, include nerve injury, infection, injury to the deltoid, stiffness and tendon re-tear. Typically after surgery, patients have to keep their arm in a sling for the first four to six weeks. Physical therapy follows for the next six to 12 weeks, and most patients regain full use of their arm four to six months after surgery.
PUTTING PAIN IN REVERSE: One procedure that was FDA approved in 2004 offers relief to some patients who suffer long-term rotator cuff tears with arthritis. During the procedure, called Reverse Shoulder Replacement, surgeons put in place an implant that's designed so that the ball portion of the shoulder is attached directly to the shoulder blade, while the socket is placed at the upper end of the arm bone. By reversing the anatomy of the shoulder, surgeons provide eligible patients with a drastic improvement in their mobility.
FOR MORE INFORMATION, PLEASE CONTACT:
Erica Brinker
Public Relations
The Core Institute
(866) 974-2673