Does a Rotator Cuff repair surgery accelerate shoulder arthritis?
THE DOWNSIDE OF ROTATOR CUFF SURGERY? (Orthopedics This Week)
Joint, Cartilage Damage Caused by Rotator Cuff Surgery?
A new study indicates that patients showing up in your office for joint replacement or other surgery may have had earlier damage done to their joint structures due to a previous rotator cuff tear. Louis J. Soslowsky, Ph.D. is the Director of McKay Orthopaedic Research Laboratory at the University of Pennsylvania. Dr. Soslowsky, who is also the Director of the Penn Center for Musculoskeletal Disorders, told OTW, “We received a grant from the NIH/NIAMS [National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases] to study when one should operate on a rotator cuff tear and the effects of that tear or surgery on the whole joint. There are patients who—even if the joint function is intact—had cartilage and other joint damage. A particularly interesting aspect of this was that we looked at the role of the biceps.”
“One group of surgeons typically cuts the biceps in the presence of a rotator cuff tear, believing that the biceps is a key source of pain and functionality wasn’t adversely affected without the biceps; the other group doesn’t cut. One of the things we did in our rat model was to hypothesize that detachment of the biceps in the presence of a supraspinatus or infraspinatus tear would affect the functioning and mechanical properties of other tissues like the glenoid articular cartilage. To our surprise, we found that detachment of the biceps actually improved shoulder function and created less damage when we already had an infraspinatus of supraspinatus tear. In the presence of either of these tears there was a disruption of force balance at the joint, both superiorly and posteriorly. The biceps is anterior but when the force is disrupted you are actually altering the anterior force, which seems to create better balance.”
“This work is especially important because this associated joint damage can go unrecognized for years until someone shows up for a joint replacement or other surgery.”