A minimally invasive approach to ending chronic shoulder pain
Cyndee Kotler of Cherry Hill endured nearly two years of recurring trouble with her right shoulder. "By Thanksgiving of 2003, the pain was so horrible it was affecting everything I did," she says. "I couldn't play tennis, much less dry my own hair. I couldn't even sleep; it hurt so much."
Kotler was diagnosed with a torn right rotator cuff by Virtua Health orthopaedic surgeon, Merrick Wetzler, MD. Because it was not a massive tear, Dr. Wetzler told Kotler she was a perfect candidate for minimally invasive arthroscopic surgery.
Says Dr. Wetzler, "I recommend to patients that if they can avoid surgery by rehabilitating the shoulder first, they should. But, when the pain begins to interfere with every day life, then it is time to consider surgical options."
Latest technology
"Until recently, open surgery was the only medical treatment available for torn rotator cuffs," says Virtua Health orthopaedic surgeon, Mark Schwartz, MD. "However, thanks to advancements in technology, minimally invasive arthroscopic rotator cuff repair is now an option for many patients," he says.
Because arthroscopy does not involve cutting through the deltoid muscle, "patients generally experience less scarring and less pain immediately following arthroscopic surgery," says Dr. Schwartz. "Plus, they can begin rehabilitation usually within a week after surgery."
Dr. Wetzler says the success rate for arthroscopy is "excellent, particularly now that some incredibly strong suture materials are available."
Dr. Schwartz explains the procedure: "It typically begins with the surgeon making three, sometimes four, incisions in the shoulder. An arthroscope (tiny camera) that helps guide the surgery is inserted in one of the incisions. Another incision is used for a catheter to flush water into the shoulder to move blood away from the tendon so that the surgeon can see the tear. A suture is passed through the remaining incisionss and through the tendon. Once all the stitches are made, using the same incision in the shoulder, the surgeon tightens and knots the suture before securing it onto the shoulder bone with an anchoring device."
Ending the pain
Because both Drs. Wetzler and Schwartz specialize in arthroscopic rotator cuff repair, they are experienced in recognizing when a patient is an appropriate candidate for the technique. "Each tear has its own demands," says Dr. Wetzler. "You can't treat them all the same."
Dr. Wetzler says that because Kotler's tear was neither massive nor pulled too far away from the bone, arthroscopic repair was a viable solution for her. Kotler recalls: "I thought if I just ignored it, the pain would go away, but it didn't. So, I was very willing to have the surgery."
Now, two years after arthroscopic repair, Kotler reports that: "It's been absolutely amazing. It was one of the best things I ever decided to do. And, since I'm not in pain any more, I am in a much better mood most of the time, too."
An added bonus? Says Kotler, "My tennis partner thinks I'm an even better player than I was before."
Physician profiles
Mark Schwartz, MD, is a board-certified orthopaedic surgeon. Dr. Schwartz graduated from Mt. Sinai School of Medicine in New York. He completed a residency in orthopaedic surgery at Mt. Sinai Medical Center, and a fellowship in sports medicine and arthroscopic surgery at Hughston Orthopedic Clinic in Columbus, GA.
Merrick Wetzler, MD, graduated from Temple University School of Medicine. He completed a residency in orthopaedic trauma and general orthopaedics at Boston University Medical Center. Dr. Wetzler earned a fellowship in sports medicine at Thomas Jefferson University Hospital. He is a board-certified orthopaedic surgeon.