Superior Capsular Reconstruction for Massive Rotator Cuff Tears 2017

•

1 like•1,714 views

SCR for massive rotator cuff tears is increasingly popular. We present our indications, development and technique.

Health & Medicine

@thearmclinic
Superior Capsular
Reconstruction
Lennard Funk

Martyn Snow

@thearmclinic
2012
• Teruhisa Mihata - SECEC Travelling Fellow

@thearmclinic
2013
• Visit to Osaka, Japan

@thearmclinic
2013 - 2014
• 2 cases with Fascia Lata autograft

• Donor site issues

• overnight stay

• patient acceptance

• Poor quality tissue

@thearmclinic
2015
• Martyn Snow, Birmingham

@thearmclinic
Indications
• Irreparable Superior Cuff tear

• Intact / reparable posterior &
anterior cuff

• Younger active patient

@thearmclinic
Indications
REPAIR
YOUNG
OLD
LAT
DORSI
DEBRIDE
DELTOID
REHAB
REVERSE
SCRC
PAIN WEAK
HORN-
BLOWERAGE

@thearmclinic
Technique
courtesy Martyn Snow

@thearmclinic
THANK YOU

MERCI
lenfunk@shoulderdoc.co.uk

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the common questions patients will ask once they have had a scan and a tear has been reported, particularly if they have had no injury of trauma, they ask what caused my tear. If I have a tear what can you do to fix it, it’s got to be fixed. How can I get better if it is not fixed. I have already had physiotherapy and that didn’t fix it so how will more physiotherapy. Some patients who are not keen on surgery, do I really need to have an operation. I have not had an injury. there are multiple options thrown into the mix here which we need to consider for an individual patient. The below illustration shows a very rough decision making tool that I would use in determining surgical or treatment options for particular patients. A younger patient who has both pain and weakness with a massive cuff tear, if it is partially repairable a biological augment would be suitable.  If their predominant weakness is external rotation i.e. a positive Hornblower sign but good elevation, a lat dorsi tendon transfer. For an older patient who has a predominant weakness but no significant pain, deltoid rehabilitation programme is indicated. If they do have pain, a suprascapular nerve procedure such as an ablation would be beneficial. For those that have significant pain and weakness with failed non-operative options, a reverse shoulder replacement would be the best option. The balloon as we said, has a very limited place and this is for the older patient with slight loss of function and pain with higher demands. For those that have more significant pain and elevation weakness, a superior capsular reconstruction would be my preferred option.

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Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye. Follow us on: Pinterest Introduction Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing . Early Life and Career Childhood and Athletic Beginnings Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle. Transition to Acting Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness. Fitness Regimen Workout Routine Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show. Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles. Importance of Flexibility and Mobility In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit

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1. @thearmclinic Superior Capsular Reconstruction Lennard Funk Martyn Snow

2. @thearmclinic 2012 • Teruhisa Mihata - SECEC Travelling Fellow

3. @thearmclinic 2013 • Visit to Osaka, Japan

4. @thearmclinic 2013 - 2014 • 2 cases with Fascia Lata autograft • Donor site issues • overnight stay • patient acceptance • Poor quality tissue

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