Gabriella E. Ode, MD, sports medicine surgeon at HSS reflects this approach, emphasizing that success is not defined by the procedure alone but by whether patients are able to return to the activities and quality of life that matter most to them.

From shared decision-making to recovery, access to care, and multidisciplinary collaboration, her approach reflects a broader movement in medicine: improving not just the operation, but everything that surrounds it.

Read the full article at beckersspine.com.

Golfers may be prone to injury due to the shoulder movement involved in repetitive golf swings, which puts stress on the muscles and tendons, Dr. Simovitch explained. To avoid a rotator cuff injury, he advises players to maintain good form, strength and flexibility. They may want to consult a physical therapist or certified trainer or find exercises from a reliable source online.

For golfers experiencing symptoms that don't improve with rest after a week or two, he recommends consultation with a health care provider.

Read the full article at magazine.essential.golf.

Dr. Simovitch said torn rotator cuffs are the majority of what he sees in his practice and are very common among athletes of all ages and become more prevalent as people get older. 

According to Dr. Simovitch, the most common symptoms to look out for are night pain, reduced range of motion, and loss of shoulder strength. 

In terms of treatment, some patients do well with physical therapy and injections.  For others with profound symptoms who haven't responded to these modalities, a conversation about surgery is typically the next step. 

Dr. Simovitch underscored the importance of warming up and conditioning before working out and encouraged people to be careful of overhead activities particularly with weights.

This episode aired live on March 10, 2023. Listen to the podcast at podcasts.apple.com. 

According to Dr. Dines, “People as we get older often tear their rotator cuff which is a group of muscles on the shoulder that help elevate the shoulder and elevate it we use it for everyday activities playing sports it's very important to shoulder function if it tears it can be very painful.”

Dr. Dines is cautiously optimistic about the new technique. “For a small portion of patients, having this balloon which we didn't have before potentially becomes a good treatment option. I say potentially because for me personally, I need to see more data,” he noted.

This segment aired during the 5pm evening news on October 20, 2021. Watch the full segment at Fox5ny.com.

Dr. Rodeo explained the exploration to make joint replacements more effective. HSS laboratories are testing whether injecting cells derived from human umbilical veins into the muscle and tendon of an injured rotator cuff will stimulate stem cell activity and promote better repair after surgery. He affirmed the aim is to conduct a similar trial with the stem cells for cartilage repair.

According to Dr. Rodeo, “If we can modulate that basic immune and inflammatory response, it may have a profound effect on tissue repair and tissue healing.”

This article appeared in print on September 10 and online at WSJ.com. A subscription is required to access.

Dr. Rodeo said, “I am pleased to lead this trial investigating the efficacy of Icellator-generated SVF in patients after rotator cuff repair. There is a significant clinical need to improve outcomes for these patients and SVF injection has shown promise in early research.”

Read the full article at ManufacturingChemist.com.

Additional coverage: BeckersSpine.com

Dr. Simovitch explained opioids are still prescribed to control pain, however much has changed over the last two years. Surgeons have made a concerted effort to minimize and sometimes eliminate the use of opioids after surgery because of the serious side effects and unanticipated consequences of prolonged opioid usage after surgery. In place of opioids, surgeons will now often use multimodal anesthesia. For example, prescribing acetaminophen alongside an anti-inflammatory medication can mitigate pain when used in conjunction with nerve blocks. Ice is also an important aspect of pain control. Nerve blocks historically helped for the first eight to 16 hours after surgery, but when they ceased to work (when the numbing medication wore off), patients would frequently have severe rebound shoulder pain.

Dr. Simovitch continued to say at HSS Florida there is a commitment to increasing the use of multimodal anesthesia and nerve blocks for shoulder surgery as alternatives to opioids, and have yielded very positive results.

This article appeared in the print edition on January 31, 2021.

Dr. Altchek explained there are two major groups of tears, partial (some of the tendon remains attached to the bone at the tear site) or full thickness (none of the tendon remains attached). Both types can be caused by one or a combination of factors, including trauma (such as a fall), impingement from a bone spur on part of the shoulder blade (acromion), or degeneration due to tissue aging.

Symptoms of a rotator cuff tear are shoulder pain and a sense of weakness, particularly when performing overhead activities like throwing a ball. Several other shoulder conditions, including arthritis, tendonitis, and disorders of the biceps tendons can exhibit similar symptoms. Diagnosis requires an MRI scan or ultrasound, with an MRI considered the gold standard.

Dr Altchek cited most patients with partial tears can be managed with conservative treatment, such as nonsteroidal anti-inflammatory medication, cortisone injection or platelet rich plasma (PRP), and physical therapy. In contrast, people with full thickness rotator cuff tears have the best chance at remaining active with an arthroscopic rotator cuff repair. This surgical procedure is performed with regional (local) anesthesia as an outpatient, meaning an overnight stay at the hospital is not required.

This article appeared in the print edition on January 10, 2021.

“For tendon type injuries, I think what we’ve found is unfortunately in the shoulder, tendons don’t heal. If you tear your rotator cuff and it’s a full tear, a complete tear, that tear is not going to heal. That’s changed our approach. While physical therapy can be incredibly important for partial tears, labral tears, and a variety of different things, when it becomes a full tear we’re much more likely to talk about surgery at an earlier point. We also have some newer techniques to repair tendons. There are times when the tendon tear is so large that you can’t fully reconstruct it with the patient's own tissue. So there has been work with graft procedures and biologics to be able to try and reconstruct a tendon that doesn’t exist anymore. We’re not totally there yet, but I think we’re making some great advances and it does give us opportunities we didn’t have before.”

Dr. Blaine continued, “On the arthritis side, we also have been able to make a lot of advances in that area. Preservation – so trying to preserve the patient’s bone and as much of their anatomy as we can, so if they ever needed further procedures in the future, we would have the ability to do them.”

Listen to the podcast at podcasts.apple.com/us.

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

When asked why of all the salvage procedures SCR was chosen for study, Dr. Dines said, “We see a significant number of patients with complicated rotator cuff tears or re-tears that may not heal if operated on using standard rotator cuff repair techniques. Prior to the invention of the SCR, many patients required a reverse shoulder replacement.”

He added, “While reverse shoulder replacements work great in many patients, they don’t last forever so using them in younger patients becomes problematic. Finding a solution to this significant clinical problem was something I was very interested in. When SCR came about it provided hope for these most difficult situations. There was a lot of excitement initially. However, with any newer technique, it is always important to step back after doing some of them to rigorously analyze the results to make sure that patients are benefitting from the technique as much as we expect them to. I think this was the main impetus for the study…..to critically analyze our results which will help us do a better job selecting patients who are good candidates for the procedure and to be able to counsel them better with regards to postoperative expectations.”

Regarding additional work to be done in this area, Dr. Dines noted, “Future studies will focus on three areas: 1. Improving the repair construct: while the overall concept of the SCR is the same for all surgeons, people have slightly different ways to fix the graft or even use different grafts. We are doing studies in our biomechanics lab to try to figure out the best/strongest biomechanical construct for the SCR. 2. Delineating indications: we are getting more granular with our data to figure out which patients are the best candidates for the procedure. Are their certain variables that make a given patient a better or worse candidate for the procedure? 3. Long term outcomes: because this is a relatively new procedure, studying the longer term results is critical.”

Read the full article at Orthospinenews.com.

Dr. Dines and colleagues looked at data from 72 patients who had undergone arthroscopic superior capsular reconstruction with dermal allograft at HSS between 2012 and 2017. Almost half of the patients in the study had a history of failed rotator cuff repair. According to data collected via patient-reported outcome surveys including Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Surgeons (ASES) and University of California at Los Angeles, most of the patients experienced significant improvements in forward elevation, abduction, and external rotation after survey.

“This technique has proven to be effective for patients with irreparable tears,” said Dr. Dines. “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.”

Dr. Dines and his colleagues plan on future research to look at long-term outcomes and results.

Read the full article at ryortho.com.

Additional coverage: Healio.com/news/orthopedics

In their review, Dr. Carr and Dr. Rodeo evaluate the basic science and clinical evidence for the most commonly used biologic agents for treating common shoulder pathologies (i.e., rotator cuff tears, osteoarthritis, and tendinopathy), to help physicians better understand the terminology for the most commonly used biologic agents; review the current literature on the use of various biologic agents in the treatment of the most common shoulder pathologies; and highlight emerging therapies and potential future applications of biologic agents in the management of these shoulder pathologies.

While the outlook may be positive, Dr. Carr and Dr. Rodeo advised that further laboratory and clinical research is needed, to define optimal formulations, dosing schedules, and approaches for various tissues and injuries. As the safety and efficacy of these approaches are further defined, changes in the regulatory environment at the FDA level may also aid progress.

“Orthopedic surgeons must be well informed when discussing biologic agents with patients," added Dr. Rodeo. "It is paramount that orthopedic surgeons provide leadership in this area and work toward developing practice guidelines and policies for the use of biologic agents. A rigorous approach to the use of 'regenerative medicine' therapies and the maintenance of high clinical and research standards are required to move the field forward."

Read the full article at News-medical.net.