Dr. Michael McDermott and Neema Pourtaheri M.D. of Santa Rosa Orthopaedics discuss the findings on patients with severe damage to the rotator cuff muscles who benefit long term from “reverse” shoulder replacement.
An exciting new study just released by The Journal of Bone & Joint Surgery revealed that patients under the age of 60 who have severe damage to the rotator cuff muscles gain long-term improvement with reverse total shoulder arthroplasty (RTSA) technique. The majority of patients in this study reported that they were satisfied with the outcomes of RTSA as much as a decade or more later.
“This study is particularly important for patients with otherwise irreparable tears of the rotator cuff muscles,” explained Dr. Michael McDermott, board certified orthopaedic surgeon specializing in sports medicine and complex reconstruction and minimally invasive procedures of the knee, hip and shoulder. “These patients are more likely to have immobility issues of the shoulder due to pain and damage to the muscles and joint. In many instances they have very limited movement in the shoulder and find it difficult if not impossible to lift the arm.”
Researchers explained that patients exhibiting these symptoms typically gain only slight benefit from standard shoulder replacement using conventional implants, which depend on healthy rotator cuff muscles to provide shoulder movement.
“As in this study, we see patients with severe damage to the support muscles of the rotator cuff as benefiting most from the RTSA technique,” said Dr. Neema Pourtaheri who specializes in general orthopaedics including arthroscopy, fracture care, joint replacement and minimally invasive procedures. “This type of surgery uses a unique implant that forces alternate muscles to move the shoulder, because of the design of the artificial ball and socket, which are essentially reversed. This takes the stress off of the rotator cuff muscles that may have otherwise been damaged.”
To address concerns about how well the results of RTSA hold up over time, the new study focused on long-term outcomes of RTSA in patients under age 60. The subjects of the study underwent follow-up examination between eight and 19 years after surgery. Three patients had RTSA in both shoulders, for a total of 23 procedures. Compared to their preoperative status, most patients had substantial long-term improvement after RTSA. Patients’ ratings of “subjective shoulder value” improved from 20 percent to 71 percent. Overall, shoulder movement and strength increased, while pain decreased. The improvement was similar for patients with and without prior shoulder surgery.
“Even taking in the rate of complications for the patients in this study which presented in 39 percent overall, only two were considered failures and most continued to receive benefit from the surgery for years, if not decades. This gives a tremendous amount of hope for the vast majority of patients who opt to have this procedure,” explained Dr. McDermott.
“Patients with rotator cuff damage typically have very few options for treatment,” added Dr. Pourtaheri “RTSA is one treatment that directly appeals to their unique situation, and in most patients, provides a lifetime of relief.”
About SRO’s Total Joint Replacement Program
SRO is a leading destination for total joint replacement surgeries of the hip, knee and shoulder in Northern California. The program is facilitated by five board certified surgeons specializing in total joint replacement. SRO’s state-of-the-art sports medicine and rehabilitation center provides veteran physical and occupational therapists, medical assistants and in house diagnostic imaging to patients. For more information about SRO surgeons, visit srortho.com or call 707.546.1922.
About Dr. McDermott
Dr. Michael McDermott is a board certified orthopaedic surgeon specializing in sports medicine and other orthopaedic problems, with emphasis on arthroscopic, complex reconstruction and minimally invasive procedures of the knee, hip and shoulder. Dr. McDermott has specialized training in reverse total shoulder as well as Mako Robotic assisted patient specific hip and knee replacement.
Dr. McDermott is co-director of The Sports Medicine Center at SRO. He is experienced in advanced arthroscopic and reconstructive surgery of the knee and shoulder, in addition to sports medicine, adult reconstructive, joint replacement, minimally invasive procedures, as well as general orthopaedic surgery. Dr. McDermott’s particular areas of interest include knee ligament reconstruction, shoulder stabilization and rotator cuff surgery, and he has developed a special interest in repair of the posterior cruciate ligament and multiple ligamentous injuries about the knee. He also applies his expertise in the treatment of young patients with damaged meniscus and articular cartilage, to include meniscal repair and transplantation, knee re-alignment surgery, and advanced repair and resurfacing techniques for articular cartilage injuries.
For a consultation, please call 707-546-1922 and request an appointment with Dr. McDermott.
About Neema Pourtaheri, M.D.
Dr. Pourtaheri is a board certified orthopaedic surgeon with sub-specialty interest and fellowship training in shoulder and elbow surgery. Throughout his undergraduate studies, residency and fellowship, he published several award–winning works on orthopaedic conditions and treatments.
Dr. Pourtaheri has trained alongside some of the world’s finest orthopaedic surgeons and brings invaluable medical expertise about the latest advancements in shoulder and elbow care. In addition, he practices general orthopaedics including arthroscopy, fracture care, joint replacement and minimally invasive procedures. Dr. Pourtaheri is Board Certified by the American Board of Orthopaedic Surgery and a member of the Arthroscopic Association of North America (AANA) and the American Academy of Orthopaedic Surgeons (AAOS). For a consultation, please call 707-546-1922 and request an appointment with Dr. Pourtaheri.