SHOULDER
Living with persistent shoulder pain due to an irreparable rotator cuff tear can be challenging. For those with minimal arthritis, an innovative surgical procedure combining tuberoplasty with the use of an ArthroFlex dermal patch as an interposition graft offers hope. This blog will help you understand what this procedure involves, its benefits, and what to expect during recovery.
What is Tuberoplasty with ArthroFlex Dermal Patch?
Tuberoplasty is an arthroscopic surgical procedure aimed at lightly debriding the bone where the rotator cuff inserts (humeral tuberosity) in the shoulder to create a smoother surface then fixing a dermal allograft (cadaver) thick patch over the tuberosity. This helps to reduce pain and improve shoulder function by minimizing friction or abutment of the humeral head and the overlying bone (acromion). Thus creating an “interposition” graft.
The ArthroFlex dermal patch is an acellular dermal matrix graft, meaning it’s a biological tissue graft that provides a scaffold for tissue regeneration. The goal is to reduce pain and hopefully improve function in a patient with minimal arthritis, but no repairable rotator cuff.
Who Can Benefit from This Procedure?
This procedure is particularly beneficial for patients with irreparable rotator cuff tears and minimal arthritis. These individuals often experience significant shoulder pain and reduced mobility, and traditional rotator cuff repair methods are not viable due to the extent of the damage. The combination of tuberoplasty and the ArthroFlex dermal patch offers a new option for these patients, providing pain relief and improved function.
How is the Procedure Performed?
The procedure is typically done arthroscopically, involving small incisions and a camera to guide the surgeon. Here’s an overview of the steps involved:
1. Preparation: You’ll be placed under general anesthesia to ensure you’re comfortable and pain-free.
2. Incisions: Small incisions are made around the shoulder, and an arthroscope is inserted to provide a clear view of the joint.
3. Tuberoplasty: The surgeon uses specialized instruments to smooth and prepare the greater tuberosity of the humerus.
4. ArthroFlex Grafting: The ArthroFlex dermal patch is placed over the area of the rotator cuff tear, acting as a scaffold for new tissue growth and improving shoulder stability. It is fixed with all-suture or plastic anchors at the corners with sutures placed through the graft.
5. Closing Incisions: The incisions are closed, and the shoulder is bandaged.
The entire procedure usually takes less than an hour, and patients can return home the same day.
Recovery and Rehabilitation
Recovery from tuberoplasty with ArthroFlex dermal patch involves several stages:
• Initial Recovery: You may experience some discomfort and swelling after surgery. Pain medications and ice packs can help manage these symptoms.
• Physical Therapy: Physical therapy is essential for restoring shoulder strength and flexibility. Your therapist will guide you through specific exercises tailored to your recovery.
• Gradual Improvement: Over the following weeks and months, you should notice gradual improvement in pain levels and shoulder function.
Most patients can return to their normal activities within a few months, although complete recovery can take up to six months. Adhering to your surgeon’s and physical therapist’s instructions is crucial for optimal results.
Benefits and Risks
A tuberoplasty offers several benefits, including significant pain relief, improved shoulder function, and enhanced stability. However, like any surgical procedure, there are potential risks, including infection, nerve damage, and complications related to anesthesia. Also, the procedure doe not replace your rotator cuff. If functional impairment (loss of motion and strength) are your major symptoms, there may be other better procedures for patients with an irreparable rotator cuff tear. These may include, tendon transfers or shoulder replacement.
Conclusion
For patients with irreparable rotator cuff tears and minimal arthritis, a tuberoplasty with a dermal patch provides a promising solution. By using a biological graft as an interposition between the humerus and the acromion, this procedure may significantly reduce pain and improve shoulder function. If you’re considering this treatment, discuss it with your orthopedic surgeon to determine if it’s the right option for you.
Every patient’s situation is unique, and your healthcare provider can offer personalized advice based on your specific needs. With the right care and rehabilitation, you can look forward to a better quality of life and improved shoulder health.
