Question:I had a severe rotator cuff tear that was repaired but didn't hold. The surgeon doesn't think another rotator cuff surgery is a good idea for me. Is there anything else that can be done? I'm starting to get arthritis in the joint and it seems to be progressing quickly.
Answer:Treatment and especially successful treatment of severe rotator cuff tears has been a challenge for many years. This is especially true when the patient also has severe shoulder joint pain.
A new shoulder implant is being used and studied for this kind of problem. It's called the Reverse Shoulder Prosthesis (RSP). It has a ball and socket design that helps restore shoulder function and relieves pain in patients with a rotator cuff-deficient shoulder.
It does this by changing the way the soft tissues pull on the shoulder. Instead of pulling the humerus (upper arm) in towards the scapula (shoulder blade), the force is directed through the center of the humerus.
Changing the direction of the force of the rotator cuff on the shoulder joint creates stability in the joint. Instead of an upward movement of the humeral head with respect toward the socket in the scapula and a loss of joint space, the RSP resists the pull of the muscles. The design is perfect for patients with a deficient rotator cuff that can't be repaired in a shoulder joint with severe athritis.Mark Frankle, MD, et al. The Reverse Shoulder Prosthesis for Glenohumeral Arthritis Associated with Severe Rotator Cuff Deficiency. In The Journal of Bone & Joint Surgery. September 2006. Vol. 88-A. Supplement 1. Part 2. Pp. 178-190.
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