Bryn Mawr Hospital
Rotator Cuff Tears are Common among Baby Boomers

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BRYN MAWR, Pa., August 2008 —  Shoulder pain from a torn rotator cuff is becoming more common as the baby boomer generation continues to live as active a lifestyle as possible. Kevin B. Freedman, MD, of Bryn Mawr Hospital’s Orthopedic Center, expects no let-up in the demand for rotator cuff repairs as active baby boomers refuse to settle for less than they’re capable of doing.

“I see some patients who come in with a traumatic injury, such as after a fall, but the most common reason I see patients is chronic pain from wear and tear that worsens over time, limits their overhead or reaching activities, and causes pain at night that interferes with sleeping,” he says.

Dr. Freedman, who estimates he fixes several hundred rotator cuff tears a year, adds orthopedic surgeons hope that new techniques for repairing these tears will produce more lasting results for patients suffering from the debilitating shoulder condition.

“Rotator cuff injuries are one of the most common reasons patients see a physician every year,” said Dr. Freedman. “We can manage some problems, such as pulls and strains, with anti-inflammatory medications or physical therapy. But a rotator cuff tear can’t heal itself.”

The rotator cuff is a group of four tendons, each attached to a muscle, which helps to move the shoulder, elevate the arm, and provide stability and strength to the shoulder joint. While the shoulder is the most movable and flexible joint, it is one of the most fragile. This flexibility makes it prone to sudden injury—the major league pitcher who tears a rotator cuff—or a tear that occurs through chronic wear.

Without a fluid shoulder motion, everyday tasks would be impossible—from reaching for a can on a supermarket shelf to shampooing hair. Surgery corrects a tear, but the problem facing Dr. Freedman and other orthopedic surgeons is that as many as half of patients retear the repaired rotator cuff.

New techniques, including a stronger configuration of sutures to reattach the tendon to bone, and a double row of sutures instead of a single row, are showing promise of maximizing the strength of the repair, according to Dr. Freedman.

Dr. Freedman says he uses the double-row repair in a quarter to a half of the rotator cuff procedures he does as data is starting to support the idea that the technique strengthens the anchoring of the tendon to the bone, reestablishes the normal rotator cuff footprint, and increases the contact area for healing.

If he is not using the double-row technique, Dr. Freedman says he employs a variation of the single-row of sutures in nearly all of his other procedures. By using a more complex alignment of the sutures, a more secure repair can be attained, he said.

Both surgical techniques can be accomplished using arthroscopy, a minimally invasive procedure in which the surgeon operates through tiny puncture holes instead of open surgery. Arthroscopy can be performed on an outpatient basis and results in less pain for the patient afterward. By contrast, open surgery for rotator cuff repair is notorious for the pain that the patient experiences afterward.

Between three million and four million patients experience rotator cuff problems every year, and the number of tears requiring surgery could more than double over the next several years to 500,000 by some estimates.

Dr. Freedman advises people to see a doctor if they have had a traumatic injury that leaves them with a significant shoulder weakness, or they can’t lift their arm or have shoulder pain that persists for several months.

Contact
Frieda Schmidt
Media Relations
610-526-8298
schmidtf@mlhs.org

Published 8-11-2008