SHOULDER ARTHROSCOPY

Eric M. Parsons, M.D.

Q:

I was diagnosed with a rotator cuff tear that is too large and chronic to be repaired. I was told that I would need a reverse total shoulder replacement. Is that my only option? A: Very large rotator cuff tears, particularly those that have been neglected for a period of years are occasionally beyond repair. In such cases many surgeons have turned

to reverse total shoulder replacement as a technique to attempt to address shoulder pain and dysfunction. This is not without its potential downsides, however. Reverse shoulder replacement has among the highest rates of complication among all shoulder surgery and is not well suited for many active patients under the age of 70, as there

are questions about the longer term durability of the shoulder

prosthesis. What is more, for patients who are suffering from isolated rotator cuff problems, to replace the hard architecture of the shoulder joint (the bone and cartilage) that is in many cases in good condition is unnecessarily invasive. And once those structures are removed and replaced with metal and plastic there is no going back.

For these reasons surgeons have continued to explore alternatives to reverse shoulder replacement in patients with

the most severe rotator cuff problems. Superior capsule reconstruction (SCR) is a procedure that has provided such an alternative. SCR involves the arthroscopic implantationofasofttissue graft to substitute for deficient rotator cuff material in patients with irreparable rotator cuff repairs.

An article published in the December 2020 issue of the Journal of Shoulder and Elbow Surgery authored by Lacheta

et al compared the outcomes of patients under age 70 who underwent SCR with a similar

group that underwent reverse total shoulder replacement. At two years following surgery there was no detectable difference in pain relief and shoulder function between the two groups, with the SCR group enjoying a lower risk of complication.

Dr. Eric Parsons performed the first SCR procedure in Northeast Ohio at Lake West Hospital in 2015 and continues to rely on this procedure for select patients as it burns no bridges and offers those patients a way to avoid shoulder replacement for their complex rotator cuff problems provided they have relatively little arthritis within the shoulder. To learn more about SCR and other treatment options for treating rotator cuff tears visit www.ohioshouldercenter.com Eric M. Parsons, M.D. Ohio Shoulder Center for Arthroscopy Lake Orthopaedic Associates, Inc. 36060 Euclid Ave., Suite 104 Willoughby 440-942-1050 9500 Mentor Ave., Suite 210 Mentor 440-352-1711 www.ohioshouldercenter.com