Interesting study presented at the Orthopedic Research Society on how shoulder range of motion and stability aren’t restored fully by rotator cuff surgery.Shoulder rotator cuff surgical repair has become the standard for patients with rotator cuff tears seen on MRI and who still have pain and lost function. Most patients believe this surgery is allot like taking your car into the mechanic to replace a worn-out part in that after surgery, the shoulder will perform like new. We’ve seen patients for years who often complain of less function after surgery than they had before surgery, so this study is helpful to see why this happens. The researchers looked at the patient’s shoulder that was operated with rotator cuff surgery vs. the opposite shoulder without the surgery. They used sophisticated high speed x-ray to check on how much the shoulder joint moved. The shoulder movement was analyzed at 3, 12, and 24 months after surgery. They concluded that shoulder strength and joint stability as well as range of motion wasn’t restored. What long-term implications might this have? Shoulder stability is crucial to protect the shoulder joint long-term. Lost range of motion also means that other joints will be have to be used more to compensate. The reason? Shoulder rotator cuff repair is a big surgery that can reconnect severed rotator cuff tendons, but often these tendons can’t be repaired to their pre-tear integrity. In addition, recovery times from shoulder rotator cuff surgery can be long, often in a large pillow immobilizer, which can weaken tissues. Also, fatty atrophy of the rotator cuff may set in (the muscles may get smaller and weaker and get replaced by fat tissue) and this atrophy isn’t helped by shoulder rotator cuff repair. Finally, since any surgery will generally have more secondary side effects effects of tissue damage compared to any injection, we recommend to our patients that if they have a partial rotator cuff tear, a full thickness and non-tracted tear (the ends of the tear are still together), or severe tendinosis (the tendon is aggravated and perhaps frayed), that they try stem cell injection therapy before considering surgery.
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