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Orthopaedic Surgery

 News Release - March 7, 2006

Rotator Cuff Surgery Brings Significant Relief to Patients with Multiple Medical Problems

Orthopaedic research suggests improved shoulder pain and movement in certain patients post-surgery

ROSEMONT, Ill., March 7 (HSMN NewsFeed) -- People suffering from multiple medical conditions report greater improvement in their shoulders after rotator cuff surgery than patients with no other preoperative disorders, according to a new study published in the March 2006 issue of the Journal of Bone & Joint Surgery. Despite suffering from more pain and limitation of shoulder function before surgery, patients with increased numbers of medical problems actually had greater overall improvement of shoulder pain and function and equivalent pain and function compared to patients with fewer medical conditions.

Rotator cuff problems were the reason for more than 4.4 million physician visits in 2003, according to data from the National Hospital Discharge Survey and the National Ambulatory Medical Care Survey, 2003. Responsible for lifting and rotating the arm, the rotator cuff is comprised of the muscles and tendons that surround the top of the upper arm bone, holding it in the shoulder joint.

While surgery is not always required to treat rotator cuff tears -- and was necessary for less than 1 percent of Americans who visited a physician for this condition in 2003 -- it is an effective way to restore mobility and relieve pain in patients who do not respond to non-surgical treatment, including anti-inflammatory medication and rehabilitation exercises.

"We expected to find that patients with more medical problems before surgery would report more discomfort in their shoulders after surgery," said Andrew Green, MD, lead study author and associate professor of orthopaedic surgery and chief of shoulder and elbow surgery at Brown Medical School in Providence, RI. "But this study shows that even people with serious conditions like heart disease and diabetes mellitus can experience significant relief from their shoulder pain and improvement in their shoulder function."

Dr. Green surmises patients' co-existing medical conditions may "amplify" their shoulder discomfort before surgery. When the shoulder problems are corrected, these other medical problems no longer seem to affect their shoulder pain. A previous study by Dr. Green and his research team found that co-existing medical disorders have a negative effect on preoperative pain, function and general health status in patients with rotator cuff tears.

The follow-up study evaluated 125 patients one year after rotator cuff surgery. The patients were evaluated using questionnaires, shoulder tests and visual analog scales to assess pain, function and quality of life. While patients with more medical problems reported a worse general health status after rotator cuff repair, they reported greater improvement in shoulder pain, function and quality-of-life scores.

"Our findings show that people with other medical issues should not be dissuaded from this kind of shoulder surgery," explained Dr. Green. "In fact, rotator cuff repair restores shoulder function so well to a point where the patients' other medical conditions no longer influence their perceived post- surgical shoulder function."

This prospective study did not receive any external funding and no conflicts of interest were reported among the researchers.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

The Journal of Bone & Joint Surgery (JBJS) is the official scientific publication of the 28,000-member American Academy of Orthopaedic Surgeons (http://www.aaos.org) or (http://www.orthoinfo.org), the premier not-for- profit organization that provides education programs for orthopaedic surgeons and allied health professionals, chAmpions the interests of patients and advances the highest quality musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (http://www.usbjd.org) -- the global initiative in the years 2002-2011 -- to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. The Academy's Annual Meeting is being held March 22-26, 2006 in Chicago.

The peer-reviewed JBJS, located in Needham, Mass., is published monthly. Abstracts are available online at (http://www.jbjs.org).


Source: American Academy of Orthopaedic Surgeons

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