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Active man with irreparable rotator-cuff tear

Active man with irreparable rotator-cuff tear

After two unsuccessful attempts at rotator-cuff repair, a sixty-year old man with an active lifestyle presented with incapacitating shoulder pain and weakness. In addition, he was unable sleep comfortably due to shoulder pain. On examination he had painful, crepitant active elevation above 90 degrees.

His MRI revealed retraction of the supraspinatus to the glenoid level and a chronic tear in the subscapularis.

He elected to proceed with a smooth and move procedure (see this link). In surgery, the supraspinatus was irreparable. His intraspinatus upper third was defective.

He began range-of-motion exercises, both active and passive, immediately after the surgery.

At nine months after surgery he came by for a followup, reporting that he was sleeping comfortably and demonstrated the active motion shown in the images shown below with his permission.

Comment: There are many reported approaches to irreparable supraspinatus and subscapularis cuff tears, including a subacromial balloon, a superior capsular reconstruction, a biologic graft, tendon transfers, partial repairs and reverse total shoulder (see this article by our current shoulder fellow, Mihir Sheth  link). The smooth and Move procedure is a simple, safe and inexpensive ,…

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