Shoulder Pain
Mary Jane Pierro was unable to comb her hair or reach into a cupboard for a dish. Buttoning a shirt was even difficult as a result of severe rotator cuff arthropathy, which made it impossible to raise her arm above her shoulder.
"I'd gone a year and half without the full use of my right arm. You learn to adapt, but it was becoming exceedingly difficult to do day-to-day care of myself," said the 77-year-old Ms. Pierro, who was also recovering from breast cancer at the time.
Disease
She was initially told that there was nothing that could be done to repair her shoulder. Her only option was to try physical therapy. That all changed in 2004 when she learned of a new technique called a reverse total shoulder replacement. Within six weeks of the surgery, she was able to raise her arm above her head with no pain.
"I can do everything now that I couldn't do before," Ms. Pierro said. "I have regained my independence."
Michael Levine, M.D., chief of the Division of Orthopaedic Surgery at The Western Pennsylvania Hospital, performed the operation on Ms. Pierro. He is one of several surgeons within the West Penn Allegheny Health System who have been extensively trained in the new technique, a list that also includes Allegheny General Hospital orthopaedic surgeons Mark Baratz, M.D., director of AGH's Division of Upper Extremity, Christopher Schmidt, M.D., and Thomas Hughes, M.D.
Rotator cuff arthropathy is an arthritic condition in which the rotator cuff is torn and the surface of the upper arm bone is collapsed as a result of osteoarthritis. The condition progresses over time, causing pain and limited mobility of the shoulder.
"Arthropathy patients are plagued by severe pain in the shoulder, and because the rotator cuff is torn, shoulders and arms are almost impossible to raise or rotate," Dr. Levine said. "With this technique, we are not only replacing the joint, but also returning function to the muscle around the joint."
In contrast to a traditional shoulder replacement, a reverse total shoulder replacement allows more mobility because the new socket and ball are switched. With this implant, the ball is attached to the shoulder blade and the socket onto the top of the upper arm bone. By shifting the center of rotation, the strength needed to move the arm is shifted away from the damaged rotator cuff muscles and transferred to the healthier deltoid muscle.
"Patients who have this procedure understand that their shoulder may not do what it did when they were in their twenties, but now they have greater movement and freedom from pain," Dr. Levine said. "That equates to making a significant difference in our patients' lives."
The Western Pennsylvania Hospital is a 512-bed tertiary care medical center serving Pittsburgh and the surrounding region. In 2004, the Hospital became the only major teaching hospital in Pennsylvania to be recognized among the country's 100 Top Hospitals for overall performance by the Solucient Institute. In addition to the Hospital in Bloomfield, West Penn extends services to residents of the eastern suburbs through its Forbes Regional Campus in Monroeville.
AGH is an 829-bed academic health center serving Pittsburgh and the surrounding five state area. AGH has been perennially recognized by U.S. News and World Report as one of America's Best Hospitals for a number of clinical specialties, including orthopaedic surgery. The Solucient Institute has also named AGH one of the country's Top 100 hospitals for orthopedic care.