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The Shoulder Surgery Update: Innovations and Insights

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Journal of Clinical Orthopaedics | Vol 10 | Issue 1 | January-June 2025 | page: 48-52 | Clevio Desouza, Nicholas Antao

DOI: https://doi.org/10.13107/jcorth.2025.v10i01.716

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 25 March 2025, Review Date: 26 april 2025, Accepted Date: 16 May 2025 & Published Date: 30 Jun 2025

Author: Clevio Desouza [1,2], Nicholas Antao [1]

[1] Department of Orthopaedics, Holy Spirit Hospital, Mumbai, India,
[2] Centre for Bone and Joint, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India

Address of Correspondence

Dr. Clevio Desouza,
Centre for Bone and Joint, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.
E-mail: ceviod@gmail.com

Abstract

This comprehensive update on shoulder surgery highlights recent advancements in managing shoulder instability, rotator cuff tears, shoulder arthroplasty, and adhesive capsulitis. It highlights the evolution of surgical techniques, non-operative interventions, and biologic augmentation approaches. Innovations in rotator cuff repair include biologic solutions, such as platelet-rich plasma, while advancements in arthroplasty focus on tailored rehabilitation and infection control strategies. Adhesive capsulitis management now incorporates novel injection techniques and surgical options for refractory cases. This summary underscores the ongoing development of individualized treatment protocols, which are essential for optimizing patient outcomes and addressing the diverse challenges in shoulder surgery.
Keywords: Shoulder instability, Rotator cuff, Biologic augmentation, Shoulder arthroplasty, Adhesive capsulitis.

References

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21. Ribeiro FR, Nogueira MP, Costa BM, Tenor AC Jr., Costa MP. Mini-open fascia lata interposition graft results in superior 2-year clinical outcomes when compared to arthroscopic partial repair for irreparable rotator cuff tear: A single-blind randomized controlled trial. Arthroscopy 2024;40:251-61.
22. Berk AN, Cregar WM, Gachigi KK, Trofa DP, Schiffern SC, Hamid N, et al. Outcomes of subacromial balloon spacer implantation for irreparable rotator cuff tears: A systematic review and meta-analysis. J Shoulder Elbow Surg 2023;32:2180-91.
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How to Cite this article: Desouza C, Antao N. The Shoulder Surgery Update: Innovations and Insights. Journal of Clinical Orthopaedics January-June 2025;10(1):48-52.

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Home based unsupervised rehabilitation protocol following rotator cuff repair has good outcomes: A prospective study

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Journal of Clinical Orthopaedics | Vol 6 | Issue 2 |  July-Dec 2021 | page:12-15 | Rohan A Habbu

Author: Rohan A Habbu

[1] Department of Upper Limb Surgery, Prime Health Clinic Ground floor, Ram Janki Apts Subhash Road, Vile Parle East, Mumbai 400057, India

Address of Correspondence
Dr. Rohan A Habbu,
Department of Upper Limb Surgery, Prime Health Clinic Ground floor,
Ram Janki Apts Subhash Road, Vile Parle East, Mumbai 400057, India
E-mail: dr_habbu@yahoo.com

Abstract

Background: Rehabilitation after rotator cuff repair achieves good results but it involves time and costs. A simple home based program will reduce costs, time to travel and chance of exposure in a pandemic scenario. The objective of the study was to assess outcomes of home based rehabilitation protocol following rotator cuff repair.
Methods: This was a prospective study of 42 patients who underwent rotator cuff repair followed by an unsupervised home based rehabilitation protocol. The tears were identified using clinical examination and Magnetic Resonance Imaging. The cuff repair was done with mini open incision technique. The patients were taught an exercise protocol, which they did by themselves at home. There was no daily supervision by the treating surgeon or a physiotherapist. The study measured pain scores, return to work, range of motion and failures at one year.
Results: Mean duration of followup was 14 months. Visual Analogue Score for pain improved from preoperative mean 7.5 to followup mean 1.3. Disability of the Arm, Hand and Shoulder score, measured in 26 patients improved from preoperative mean 33.2 to followup mean 4.5. Range of motion improved in 39 patients. Cuff strength was normal in 39 patients. 37 patients returned to full work by three months. There were three failures with one patient developing significant stiffness and two patients showing a retear. The retear was seen in patients with large retracted tears and the repair was done under tension.
Conclusion: Home based exercise protocol for postoperative rehabilitation in rotator cuff repairs can achieve good results in carefully selected patients. The study does not recommend this for large tears with difficult repairs. Since the patients are doing the postoperative rehabilitation at home, this reduces the costs, time lost in travel and exposure to external factors.
Keywords: Rotator cuff, mini open repair, unsupervised rehabilitation, motion

References

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9. Andersen NH, Sojbjerg JO, Johannsen HV, Sneppen O. Selftraining versus physiotherapist-supervised rehabilitation of the shoulder in pa- tients treated with arthroscopic subacromial decompression: a clinical randomized study. J Shoulder Elbow Surg 1999; 8: 99–101.
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How to Cite this article: Habbu RA. Home based unsupervised rehabilitation protocol following rotator
cuff repair has good outcomes: A prospective study. Journal of Clinical Orthopaedics July-Dec 2021;6(2):12-15.

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History and Future Direction of Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

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Vol 3 | Issue 2 |  July-Dec 2018 | Page 12-15 | Teruhisa Mihata.

Authors: Teruhisa Mihata [1,2,3].

[1] Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
[2] Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, California, USA
[3] Katsuragi Hospital, Kishiwada, Osaka, Japan

Address of Correspondence
Dr. TeruhisaMihata,
Department of Orthopedic Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
Email: tmihata@yahoo.co.jp, tmihata@osaka-med.ac.jp

Abstract

Lesions of the superior shoulder capsule had been a neglected entity before I reported my technique for superior capsule reconstruction (SCR).I had noticed that patients with irreparable rotator cuff tears always had irreparable defects of the superior shoulder capsule as well as the rotator cuff tendons, because the superior shoulder capsule is attached to the undersurface of these tendons. Therefore, I hypothesized that reconstruction of the superior shoulder capsule might be useful to prevent superior migration of the humeral head and subacromial impingement in irreparable rotator cuff tears. To prove my hypothesis, our group performed a cadaveric biomechanical study in 2005. This biomechanical study showed that SCR completely restored superior stability of the glenohumeral joint, whereas patch grafting to the supraspinatus tendon (conventional patch graft surgery) only partially restored superior translation to the intact level. Consequently, in 2007,we started arthroscopic SCR for patients with irreparable rotator cuff tears. From our 10 years of experience with SCR, we conclude that arthroscopic SCR restores superior glenohumeral stability and improves shoulder function in irreparable rotator cuff tears.
Keywords: Irreparable, Reconstruction, Rotator Cuff, Shoulder, Superior capsule

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How to Cite this article: Mihata T. History and Future Direction of Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears. Journal of Clinical Orthopaedics July-Dec 2018; 3(2):12-15.

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