Torn shoulder tendons gimp shoulder mechanics and can lead to “chronic and
often unbearable pain, muscular fatigue, and severe functional disability”. A reverse prothesis and latissimus dorsi tendon transfers are a treatment but are extreme measures. A simple and effective treatment involves advancing the end of the deltoid muscle. 86% excellent or good results
J Shoulder Elbow Surg. 2010 Oct;19(7):1098-104.
Outcomes of distal deltoid release for symptomatic cuff-tear arthropathy.
Scapinelli R abstract here
- 22 elderly cases – mean age 73
- Symptoms – unremitting unbearable pain(10/10) at rest and with motion, often radiating to the distal deltoid and associated with severe movement restriction (abduction = lateral raise – often less than 45 °). Strength poor.
- Surgery – when end of deltoid released, it automatically retracts and is mattress sutured to new location 1.5-2 cm proximal.
- Results – “Pain relief at rest and on motion was total in 16 of the 22 patients (72%; standard error [SE], 9.5 %) and partial without activity compromise in 4. They all were able to sleep comfortably and without the need for medication.”
- muscle strength unchanged in 12 patients and “slightly or moderately improved” in 10 patients.
Comments: This is a horrible disease.
The authors conclusions are mouthwatering:
- Safe, easy, quick, well tolerated
- Needs no special instrumentation
- 1 day hospital stay
- Immobilization only for a few days after; rehab simple
- Complications unlikely
I hope news of this spreads quickly.