Newsroom Hospital for Special Surgery

Orthopedic Surgeon Discusses Recovery, Injury Issues For Seattle Mariners' Victor Robles

Sun, 13 Apr 2025 11:01:00 -0400

Michael C. Fu, MD, MHS, sports medicine surgeon at HSS, joined the "Refuse to Lose" podcast to talk about Seattle Mariners outfielder Victor Robles dislocated shoulder and a fracture injury.

Dr. Fu explained that Robles is at a slightly higher risk for recurring shoulder issues now, and he added that he wouldn't be "surprised" to see Robles get surgery to address the labrum tear in the offseason.

Read the full article and listen to the podcast at SI.com.

Who Knew? Joint Replacements You Never Heard Of

Thu, 09 Jun 2022 15:45:00 -0400

Autumn Years discusses various types of joint replacement, such as shoulder, ankle, wrist and small finger joint replacements as a potential treatment option for arthritis, and highlights insight from HSS experts including Geoffrey H. Westrich, MD, hip and knee surgeon, Michael C. Fu, MD, MHS, sports medicine surgeon, Scott W. Wolfe, MD, hand and upper extremity surgeon, Scott J. Ellis, MD, foot and ankle surgeon.

Dr. Westrich explained, “Advances in technology, technique and pain management after surgery have benefitted people who want to get back to activities and live life to the fullest.”

Dr. Fu said shoulder replacement is considered when first-line treatments such as pain medication, activity modification and physical therapy no longer help. “While the primary reason is painful arthritis, the procedure and results have improved to the point where it could be considered for a massive rotator cuff tear or a really bad shoulder fracture,” he added.

According to Dr. Wolfe, wrist arthritis is one of the most common and debilitating conditions treated by hand surgeons, affecting about 5 million people in the United States. Surgery to fuse together the wrist bones can alleviate pain, but motion is restricted, making it difficult to perform certain activities.

Dr. Wolfe co-designed the KinematX, a new wrist replacement, which has advantages over traditional implants. He explained, “Our extensive research into how the wrist moves helped us design a device that more closely matches the anatomy and complex motion of a normal wrist.”

Dr. Wolfe added, “As with all surgeries we perform at HSS, patients are counseled about treatment options, as well as the potential risks and benefits of each procedure. We customize treatment to the patient’s condition, activity level, needs and goals.”

“Both finger joint replacement and bone fusion relieve pain. The benefits of joint replacement are to preserve motion and function; the main advantage of a fusion is its durability,” said Dr. Wolfe.

Dr. Ellis explained that the last 15 years have brought vast improvements in ankle replacement implants and technology, making the surgery a viable option for many patients suffering from severe arthritis. Unlike knee and hip arthritis, which usually develop over time from wear and tear, ankle arthritis generally results from a severe fracture or repeated ankle sprains.

This coverage originally appeared in the Summer 2022 print edition and online of Autumn Years. The original article is no longer available online.

What is frozen shoulder? Symptoms, treatment and a possible pandemic connection.

Thu, 07 Oct 2021 17:06:00 -0400

The Washington Post reports on the symptoms and treatment for adhesive capsulitis, more commonly known as frozen shoulder, and includes guidance from Michael C. Fu, MD, MHS, sports medicine surgeon at HSS.

Dr. Fu explained, “The shoulder capsule — it’s a thin lining around the joint itself — has to maintain a delicate balance between flexibility, pliability and also integrity. Once you get into this cascade of a little bit of inflammation or microtrauma that leads to more inflammation, that just sets off the whole cycle of adhesive capsulitis, where the capsule, which is normally really thin like a piece of tissue paper almost, then becomes really thick and like cardboard, and that’s how your shoulder gets tight and you lose range of motion.”

Dr. Fu noted that early detection is important and “the hallmark of treatment for frozen shoulder is physical therapy and stretching.”

Read the full article at Washingtonpost.com.

3 Tips for Shoulder Injury Prevention

Tue, 22 Dec 2020 10:00:00 -0500

HSS sports medicine surgeon Michael C. Fu, MD, MHS, bylines an article for NBPA’s blog on shoulder injury prevention.

Dr. Fu explains that many athletic shoulder injuries can be prevented or treated non-surgically by stabilizing the scapula, strengthening the rotator cuff and maximizing shoulder range of motion.

He writes that scapular strengthening is often overlooked and can be achieved with exercises such as scapular retractions, scapular push-ups, shoulder shrugs, prone rows and wall ball circles.

According to Dr. Fu, maintaining flexibility in the soft tissues around the shoulder allows the ball of the shoulder joint to stay centered in the socket through the entire range of motion.

Read the full blog post at NBPA.com.

HSS Study: Delay in Rotator Cuff Repair Associated with “Significant” Increase Revision Surgery

Wed, 21 Oct 2020 20:46:00 -0400

OrthoSpineNews reports on the findings of an HSS study published in Orthopedics by sports medicine surgeon Michael C. Fu, MD, MHS, which found a delay in rotator cuff repair is associated with an increased risk for subsequent revision surgery.

Dr. Fu explained the key takeaway from the study, noting, “The most important result is that there appears to be an association between a delay from the time of initial rotator cuff tear diagnosis to the time of rotator cuff repair, and the need for subsequent revision rotator cuff surgery due to repair failure. We found that a delay of more than 12 months from rotator cuff tear diagnosis to rotator cuff repair was associated with a significant increase in the rate of undergoing revision surgery in the future.”

Dr. Fu added, “A significant percentage of patients I see in the office with rotator cuff tears can still be successfully treated non-surgically, and there are factors that influence their prognosis such as age, tear size, activity level, muscle quality, etc. Based on the results of this study and our clinical experience, however, patients that have failed non-surgical treatment are advised that delaying rotator cuff repair may be associated with worse outcomes. Ideally, rotator cuff repair should be performed within 12 months of their rotator cuff tear diagnosis to optimize the chances of restoring shoulder function, relieving pain, and returning to the activities they love."

Read the full article at Orthospinenews.com.

Additional coverage: Healio.com/news/orthopedics, ICJR.net

Delaying Rotator Cuff Surgery for 12 Months or Longer May Double the Odds of Needing Revision Surgery

Mon, 19 Oct 2020 08:00:00 -0400

Delaying surgery for 12 months or more after a rotator cuff tear diagnosis is associated with almost twice the odds of needing a subsequent revision surgery compared to having surgery between six weeks and one year after diagnosis, according to a retrospective study of records from thousands of patients across the United States by investigators at Hospital for Special Surgery (HSS).

The revision rate for patients with rotator cuff tears who delayed surgery for 12 months or more was 15.2 percent, versus 9.9 percent for those who had surgery within six weeks and 8.3 percent for those who received surgery within the routine period of six weeks to 12 months of diagnosis.

“Patients who have not responded to non-operative approaches for rotator cuff tears frequently ask how long they can delay surgery,” says Michael C. Fu, MD, MHS, a sports medicine surgeon at HSS and lead author of the study. “Our research was designed to investigate the relationship between delaying surgery and the need for subsequent revision due to failure of the initial rotator cuff repair.” The study was published online first on October 1 in the journal Orthopedics.

The rotator cuff is a set of four muscles around the shoulder that keeps the joint centered in order to allow the upper arm to rotate. Rotator cuff tears are common, affecting more than three million people in the United States every year. Most people recover with physical therapy, activity modification, and potentially injections. However, more severe injuries with significant symptoms that continue to affect activities and sleep despite non-surgical approaches require surgical repair. Surgeons typically perform rotator cuff surgery using minimally invasive shoulder arthroscopy. Recovery involves using an arm sling for four to six weeks and several months of rehabilitation.

For their study, the investigators examined de-identified patient records in Humana’s national private-payer insurance claims database. They identified 2,759 patients diagnosed with partial or complete rotator cuff tears who subsequently underwent arthroscopic repair between 2007 and 2016 and grouped them according to the period from diagnosis to initial surgery.

At a minimum follow-up of five years, 1,510 patients (55 percent) had early repair within six weeks, 1,104 patients (40 percent) underwent routine repair between six weeks and 12 months and 145 patients (5.3 percent) received delayed repair more than 12 months after diagnosis.

Overall, the revision surgery rate was 9.6 percent within five years of diagnosis. The differences in revision rates between the delayed repair and both early and routine repair groups were statistically significant. Delayed repair beyond 12 months of diagnosis was associated with an increased risk of undergoing revision surgery compared to routine repair, even after controlling for age and other health conditions, with an odds ratio of 1.97 (p = 0.009).

“These findings are now informing our discussions with patients about the benefits of surgery and the risks associated with delays,” Dr. Fu says. “Future prospective studies would benefit from including additional data, such as the exact time from rotator cuff injury to surgery, range of motion, imaging results and return to sport outcomes.”

New Study Finds Positive Outcomes After Arthroscopic Shoulder Superior Capsular Reconstruction

Mon, 20 Jul 2020 08:00:00 -0400

While rotator cuff injuries are quite common, rotator cuff tears can be debilitating, occurring either over time from prolonged wear and tear or from an acute trauma injury. Complete rotator cuff tears are generally repaired by arthroscopic surgery. While surgical techniques have vastly improved over the years, a high re-tear rate still exists and some tears are not even able to be repaired primarily. For these cases, several salvage procedures exist. One is superior capsular reconstruction (SCR) which uses a graft to reconstruct the superior capsule of the shoulder in the region of the irreparable rotator cuff.

A new retrospective study from Hospital for Special Surgery (HSS) evaluated 72 patients who underwent arthroscopic SCR with dermal allograft to treat symptomatic irreparable rotator cuff tears. All patients were operated on at HSS between 2012 and 2017. Nearly 42% of the patients had a history of failed rotator cuff repair.

After surgery, the overwhelming majority of patients demonstrated significant improvements in forward elevation, abduction and external rotation through their pre- and post-operative active range of motion. At follow-up appointments, patients completed various patient-reported outcome surveys including Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angeles (UCLA). Patient scores were high, averaging 80%, 78% and 85%, respectively.

Five patients required a second operation – no other complications were recorded.

“This technique has proven to be effective for patients with irreparable tears,” said Joshua S. Dines, MD, HSS sports medicine surgeon and senior study author. “As we continue to do more outcomes research, we become more precise at predicting the best candidates for each technique. While not for everyone, this has emerged as a great option for patients who may not be right for a reverse shoulder replacement.”

The authors look to perform future research evaluating the long-term outcomes and results.

This study is available online as part of the AAOS 2020 Virtual Education Experience.

Abstract Title: Clinical Outcomes following Arthroscopic Shoulder Superior Capsular Reconstruction

Authors: Daniel Hurwit, MD, Justin Chan, Michael Fu, MD, John Apostolakos, MD, Stephen Fealy, MD, Frank Cordasco, MD, David Dines, MD, Lawrence Gulotta, MD, Joshua Dines, MD.