Stitching Up Shoulders

Advances in surgery mean less pain for patients with rotator-cuff tears

The Wall Street Journal—March 21, 2011

Whether you've been relatively inactive or fairly athletic, age is the enemy of one of the most important sets of muscles in the body: the group of four known as the rotator cuff that surround the ball of the shoulder joint.

About 54% of adults older than 60 have a completely or partially torn rotator cuff, compared with just 4% of those between 40 and 60. But tears are most frequently caused by degeneration of the tendon due to age, rather than injury from sports or trauma. Studies show that tears can be managed without surgery in half of patients, mainly through physical therapy, pain medications, and avoiding activities that cause pain.

The Price of Delay

"Many patients who have a tear figure they can take six months and live with it, but left alone the tear will progress and you can get to the point where it is irreparable," says David Altchek, a surgeon at New York's Hospital for Special Surgery. Dr. Altchek says repairing torn rotator cuffs earlier with a new technique that uses a double row of sutures to fix tendons to bone, rather than a single row, is improving healing rates in his studies.

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Eric Taylor, a 62-year-old documentary filmmaker who plays sports like tennis with his right arm, says he was surprised when he began developing pain in his left shoulder. He tried to ease it by doing yoga, but after six months with no relief, he scheduled an MRI. It confirmed that a bone spur digging into a tendon had caused a tear in the left rotator cuff.

He scheduled surgery with Dr. Altchek at Hospital for Special Surgery last June, but wishes he had acted sooner. Because he waited so long, he says, his surgery required three incisions instead of one. He was surprised at how much work was involved in rehabilitation but has been diligent about his recovery and physical therapy.

Back to playing tennis now, Mr. Taylor says, "When it comes to our own bodies, as baby boomers we've always been active, and we are going to stay active any way we can."

Read the full story at wsj.com.