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Johns Hopkins Bayview News - A Shoulder to Lean On

Winter 2013

A Shoulder to Lean On

By: Martin Fisher
Date: February 4, 2013

Patients find treatment options for rotator cuff injuries

Nancy Drost, rotator cuff surgery patient
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Nancy Drost is happy to be back caring for the dogs at the vet clinic.

Nancy Drost is not the kind of person you’d expect to need shoulder surgery. A Columbia, Maryland, resident working at a veterinary clinic and accustomed to lifting and carrying 60-70 pound dogs, Drost was the picture of health. But one day, the dog she was walking bolted, wrenching her shoulder and pulling her down a hill. With her ankle shattered in several places, Drost recalls, “I didn’t even know that I had a real problem with my shoulder until I felt it give when I was lifted onto a stretcher.” In addition to tearing three of the four tendons that create the rotator cuff, her bicep tendon had snapped.

Drost’s injury was unusual. The majority of rotator cuff injuries are “wear and tear related,” according to orthopaedic surgeon Uma Srikumaran, M.D., and are due primarily to aging or overhand activities and other forms of repetitive stress. Other causes include age-related decrease in blood supply, poor nutrition or bone spurs.

Many rotator cuff injuries can be treated with rest, modifying or avoiding activities that cause pain, anti-inflammatory medication or cortisone injections. For more significant injuries, particularly traumatic injuries like Drost’s, surgery often is required. Arthroscopic surgery is the most common option, and involves small incisions made around the shoulder.

During arthroscopic surgery, a camera is inserted to see and remove inflammatory or unhealthy tissue. Finally, the injured tendons are reattached to the bone with very small metal or bio-composite anchors, which Dr. Srikumaran likens to wall anchors. Attached sutures repair the tendon. Today, newer technology is available at Johns Hopkins Bayview Medical Center, where surgeons are able to create bone tunnels for the suture without the need for anchors. This method preserves more of the patient’s own bone and leaves less foreign material inside the body.

Recovery from arthroscopic surgery progresses over several months. Most patients advance from gentle motions performed by the therapist to motion generated by the patient, followed by strengthening exercises. Many patients are back to normal activities within four to six months.

As for Nancy Drost? In her own words, she’s “back to lifting 70-pound dogs,” and has high praise for her surgical and physical therapy experience. “It’s been phenomenal,” she says. “I’ve got my full life back. I had a fabulous surgeon, and I’ve had a tremendous recovery. I can’t say enough about it.”

For more information or to schedule an appointment, call 443-997-2663.