New rotator cuff surgery shows promise

LOS ANGELES For two years, Jan Graves couldn't pick lemons from her trees, throw darts or even open a window.

"One day I woke up and the pain was incredible. Any movement at all caused pain," said Graves.

She tore her right rotator cuff. After surgery to fix it, she tore it again. Ten to 15 percent of repairs fail.

Orthopedic surgeon Dr. Kevin Kaplan did biomechanical studies for a new arthroscopic repair called a Net Bridge.

"What I've done is put in two anchors on this medial row," said Dr. Kaplan.

Anchors, sutures and a special fiber-tape are used to create a net, to compress and hold tendon to bone.

"Much like a net on the side of a mountain holding rocks on the side of the mountain, we're actually compressing that part of the tendon down, capturing it like a net and protecting it while the patient is moving his or her shoulder," said Dr. Kaplan.

This provides extra protection and strength. Five months after surgery, Graves can move pain-free.

"Oh, it's like a new lease on life. You know, it's given me more energy than anything just knowing that I'm not going to be hurting," said Graves.

Now, she's on target for an active, healthy future.

Most patients can resume active motion within six weeks, and there is a much lower risk of re-injuring the shoulder with the Net Bridge procedure than with traditional repairs.

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For people who've had past rotator cuff injuries, daily shoulder stretches and a shoulder- strengthening program can help prevent a recurrence. For people at risk for rotator cuff injuries, doctors may suggest performing regular shoulder exercises, taking frequent breaks at work if their jobs require repetitive arm and shoulder motions, resting shoulders during sports that require repetitive arm use and applying cold packs and heat pads when there is shoulder pain or inflammation.


According to the Mayo Clinic, treatment for rotator cuff injuries involves exercise therapy most of the time. Other treatments may include: Steroids Injections: This therapy involves a doctor using a corticosteroid injection to relieve inflammation and pain. Surgery: This may be an option for large tears. Sometimes, doctors may remove a bone spur or calcium deposits during surgery. Arthroplasty: Rotator cuff tears may contribute to severe arthritis over time. Doctors may use more extensive surgical options including a partial shoulder replacement (hemiarthroplasty) or total shoulder replacement (prosthetic arthroplasty). Ball-and-socket prosthesis: This is a treatment option that is now available for people who have very difficult shoulder problems. It involves using a reverse shoulder prosthesis.


Now, there's a new surgical option that's helping people with rotator cuff injuries. An arthroscopic repair called Net Bridge uses anchors, sutures and a special fibertape to create a net that compresses and holds the tendon to bone. It provides extra protection and strength while the patient moves. This procedure is designed to provide more support and anchoring than the traditional single row or even double row rotator cuff repair. "We know that the supraspinatus, which is one of your rotator cuff tendons, can generate a maximum force of about 300 Newtons," Kevin Kaplan, M.D., an orthopedic surgeon at Jacksonville Orthopaedic Institute in Jacksonville, Fla., told Ivanhoe. "This repair technique can withstand a force of up to 500 Newtons." The new surgery doesn't require an overnight hospital stay, and patients can resume active motion within six weeks.

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