[mtomaino]

Many "older" patients with poor overhead motion and pain, but a well centered humeral head in the socket may have unfixable tears of their rotator cuff. Although reverse shoulder replacement may be an option if the pain becomes too bad, there may be a minimally invasive solution even when cuff repair is not possible. If one can elevate to shoulder level, but not above, pain from a degenerative biceps tendon may be the cause.

Dr Pascal Boileau (see article reference below) has shown that a simple biceps tenotomy (or tenodesis) may help---thus obviating the need for shoulder replacement. Further, this option, which takes about 15 minutes, and can be performed as an outpatient, and does not "burn the bridge" of arthroplasty in the future. So, if you know a friend, or loved one who is disadvantaged by shoulder pain, and lack of motion, there may be hope even if their rotator cuff is not fixable.


Isolated Arthroscopic Biceps Tenotomy or Tenodesis Improves Symptoms in Patients with Massive Irreparable Rotator Cuff Tears
The article below was published in The Journal of Bone and Joint Surgery: 2007;89:747-757.