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Orthopedics
Reverse Shoulder Replacement Relieves Pain of Torn Rotator CuffWilbert Mauser of Allentown, Pa., had trouble with the rotator cuff in his right shoulder for years. He gave up bowling three years ago and could no longer pick up his grandchildren or throw a ball with them. But in January the pain became unbearable. "I couldn't move, sleep or lay down," he said.Mauser, 72, went to orthopedic surgeon and shoulder specialist James Hoffman, M.D., who ordered an MRI that found that his rotator cuff was torn beyond repair. Until now, nothing could be done for Mauser other than treating the pain. Fortunately, Hoffman was trained to perform a new “reverse” total shoulder replacement approved by the FDA in 2004. On Feb. 16, Hoffman replaced Mauser's shoulder with the Aequalis® Reversed Shoulder Prosthesis made by Tournier, Inc. -- the first time the procedure was done in the region. Hoffman is the only surgeon in the Lehigh Valley trained to perform the procedure. Operating at Lehigh Valley Hospital--Muhlenberg in Bethlehem, Pa., Hoffman worked with specially trained physician assistant Reese Williams, PA-C, to attach a metal ball to Mauser's shoulder bone using screws, and a plastic socket to his upper arm bone using bone cement – the reverse of the normal shoulder joint configuration. The deltoid muscle, not the rotator cuff, would be used to lift the arm. The procedure is the opposite of conventional shoulder replacement surgery, where the plastic socket is attached to the shoulder bone and a metal ball replaces the head of the upper arm bone -- leaving patients with some pain and the ability to lift their arms only to a 90-degree angle. The new procedure eliminates pain and gives them good range of motion. "It's very common for people in their 70s and 80s to have worn-out rotator cuffs that were once non-repairable," Hoffman says. "Now, rather than having to live with the pain and immobility, they have a solution. This procedure is very well tolerated by elderly people, even when they have other medical conditions." The three to four hour procedure is specifically designed for patients over 70 who have completely worn-out rotator cuffs. It usually involves just an overnight hospital stay and then wearing a sling for four to six. Minimal physical therapy is required. Mauser, who had 12 angioplasties to treat heart problems, is slowly regaining his range of motion. "The pain is gone and I'm starting to stretch," he said. "I'm looking forward to bowling and playing ball with my grandchildren again." This page last updated 2/12/08 04:08 PM
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