James' Story - Rotator Cuff Arthropathy

August 8, 2018

Individuals with shoulder pain seek treatment for a variety of reasons. Some people note that their shoulder pain or limited range of motion interferes with their day to day routine. Others find that the pain interrupts their sleep or keeps them from participating in hobbies they enjoy.  Regardless of the ultimate catalyst, by the time they reach out to an orthopedic surgeon like Dr. Eichten they are all ready for some relief. 

 

 

James' Story:

 

For one of our patients, James, he knew it was time to seek help when he began to have difficulty reaching over head for items. He was also no longer able to play tennis. Dr. Eichten found that James was suffering from osteoarthritis of the shoulder complicated by rotator cuff arthropathy. 

 

James was originally seen for his right shoulder in 2015. He and Dr. Eichten talked about James’ medical history, activity level, current symptoms and goals of treatment. Ultimately, James underwent a Reverse Total Shoulder Replacement.

 

A normal shoulder joint is made up of a ball (part of the humerus) and socket (part of the shoulder blade). The smooth and extensive motion of the shoulder is achieved by a combination of factors including healthy joint space, intact cartilage, and stabilization and strength provided by the muscles of the rotator cuff. 

 

The most common cause of shoulder pain in the general population is disease of the rotator cuff. The rotator cuff is made up of 4 shoulder muscles and their associated tendons which attach the muscles to the bones. When working properly, the muscles of the rotator cuff allow the shoulder to move through an incredible range of motion while simultaneously providing stability and strength. Over time, or with significant overuse, the tendons of the rotator cuff can become severely damaged or completely torn. This condition results in aching pain, especially at night when lying on the affected shoulder. With mild disease, people may only notice weakness in the arm when reaching overhead. As the degeneration of the tendons progresses, patients may have difficulty performing day to day activities such as getting dressed or brushing their hair. 

 

Osteoarthritis is also a common cause of shoulder pain in those over the age of 60. This may also occur as a result of prior injury or fracture to the shoulder joint. As we age, our healthy cartilage begins to wear out, resulting in friction and pain in the ball and socket joint of the shoulder. Common complaints include aching pain in the shoulder joint, difficulty reaching forward or overhead, stiffness, and swelling. Some people will notice a clicking or crunching sound in their shoulder with certain motions.

 

The combination of osteoarthritis and rotator cuff disease can lead to significant pain and loss of arm function. James noted that his daily routine and the activities he loved were interrupted due to his shoulder limitations. Luckily, James chose to seek the advice of Dr. Eichten. 

 

Shoulder replacement surgery is a procedure where the damaged portions of the shoulder joint (the ball and socked) are replaced with metal and plastic parts called implants. In James case, his rotator cuff was significantly damaged and Dr. Eichten recommended a Reverse Total Shoulder Replacement. In this procedure, the ball and socket are replaced but are also reversed in position. The reversal of the ball and socket configuration allows the other muscles of the shoulder joint to function in place of the damaged rotator cuff muscles. Reverse Total Shoulder replacement reduces pain, improves stability and restores range of motion of the shoulder. 

 

After undergoing surgery James stayed one night in the hospital and then completed his initial physical therapy and remaining recovery in the comfort of his own home. After about a month he transitioned to outpatient physical therapy while continuing a home exercise program. He was able to gradually return to his normal activities and returned to playing tennis after 10 weeks. 

 

In 2018, James started to have pain, stiffness and decreased range of motion in his left shoulder. He was so pleased with Dr. Eichten’s treatment of his right shoulder that he chose to return for evaluation of his left shoulder. James underwent a left Reverse Total Shoulder Replacement about 2 months ago and reports that he is recovering very well. James describes his treatment experience as excellent and reports that he would highly recommend Dr. Eichten and his team. 

 

 

Sources: 

1.       https://www.zimmerbiomet.com/patients-caregivers/shoulder/about-shoulder-pain.html#

2.       https://www.uptodate.com/contents/glenohumeral-osteoarthritis?search=shoulder%20osteoarthritis&source=search_result&selectedTitle=1~25&usage_type=default&display_rank=1

3.       https://www.uptodate.com/contents/rotator-cuff-tendinopathy?search=rotator%20cuff%20arthropathy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

 

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