Shoulder Pain: Better Outcomes

Rotator Cuff Tear

Rotator cuff tears are painful. Patients often are unable to raise their arm or put weight on their shoulder. Signs of a torn rotator cuff may include:

• Pain when you lift or lower your arm
• Weakness when you lift or rotate your arm
• Crackling sensation when you move your shoulder in certain positions

In the hands of experienced Huron Valley-Sinai Hospital orthopaedic surgeon Roland Brandt, D.O., arthroscopic rotator cuff repair — a minimally invasive technique — can be very effective in eliminating a patient’s pain and restoring strength and function to the shoulder. Dr. Brandt conducts the outpatient procedure in the hospital’s state-ofthe- art operating room using high-defi nition video to guide the precise
and miniature operating equipment.

Instead of making an incision that used to be 6 -10 centimeters, arthroscopic rotator cuff repair is done with three to four small incisions. Dr. Brandt makes these small incisions and works while looking at the rotator cuff on a television monitor. The advantages of arthroscopic rotator cuff repair are less pain, less scarring and a faster recovery.

Reverse Shoulder Replacment

A breakthrough shoulder surgery is restoring function and relieving pain for patients with a damaged rotator cuff or severe arthritis. Called a
“reverse shoulder replacement,” the procedure alters the mechanics of the shoulder by reversing the normal position of the ball and socket.

Mark Kwartowitz, D.O., a board-certifi ed orthopaedic surgeon on staff at Huron Valley-Sinai Hospital, explains that rotator cuff problems can
occur due to injury or degenerative changes. The result can be tendon tears leading to arthritis. While physical therapy, anti-infl ammatory
medications or steroid injections help some patients, others experience signifi cantly reduced movement and severe pain in their shoulders.

“In cases where the tendon can’t be repaired surgically, a reverse shoulder replacement is a good option for many patients,” says Dr. Kwartowitz. With this shoulder replacement, a metal and plastic implant places the ball onto the shoulder blade and the socket onto the top of the
upper arm bone. “With a reverse shoulder replacement, the deltoid muscle rather than the rotator cuff keeps the ball and socket in place. This increases stability, restores motion and relieves pain,” Dr. Kwartowitz comments.

Total Shoulder Replacment

If you suffer from arthritis of the shoulder joint, then total shoulder replacement surgery may be right for you.

Arthritis is a condition that affects the cartilage of the joints. As the protective cartilage lining wears away, your bones start to rub against each other. When this happens, painful bone-on-bone arthritis develops.

Total shoulder replacement surgery alleviates pain by replacing the damaged bone and cartilage with a combination of a metal and plastic implant. When shoulder replacement surgery is performed, the ball is removed from the top of the humerus (long bone in the arm or forelimb that runs from the shoulder to the elbow) and replaced with a metal
implant. The ball is attached to a stem inserted down the center of the shaft of the humerus. The socket portion of the joint is shaved clean and replaced with a plastic socket that is cemented into the shoulder blade.

Patients who have tried the usual treatments for shoulder arthritis, but have not been able to fi nd adequate relief, may be candidates for total shoulder replacement surgery.