Our Summary

This research paper discusses the relationship between bone health and rotator cuff tears, a common shoulder injury. As people get older, they are more likely to have lower bone density, conditions known as osteopenia and osteoporosis. This can be due to various reasons such as chronic illnesses, poor diet, or not getting enough sunlight, which is necessary for the body to produce Vitamin D.

When bone density is low, particularly in a part of the shoulder called the greater tuberosity, it can cause complications with rotator cuff tears. Specifically, it can weaken the strength of the surgical anchors used to repair these tears and increase the likelihood of the injury recurring, particularly in older people with larger tears.

The paper reviews the existing research on this topic and offers strategies for treating rotator cuff tears in patients with low bone density.

FAQs

  1. How does vitamin D deficiency affect bone quality and rotator cuff repair?
  2. What is the link between chronic rotator cuff tears and bone mineral density?
  3. What are the suggested treatment strategies for rotator cuff repair in patients with poor bone quality?

Doctor’s Tip

A helpful tip a doctor might give a patient about rotator cuff repair is to ensure they are taking steps to maintain good bone quality. This may include getting enough vitamin D through sunlight exposure and/or supplementation, maintaining a healthy diet rich in calcium and other nutrients essential for bone health, and engaging in weight-bearing exercises to strengthen bones. By supporting bone health, patients can potentially improve the success and longevity of their rotator cuff repair.

Suitable For

Patients who are typically recommended for rotator cuff repair are those with chronic rotator cuff tears that have deteriorated the bone mineral density of the greater tuberosity. These patients may have osteopenia or osteoporosis, which can affect the success of the repair surgery. Older patients with larger tear size are particularly at risk for reduced anchor pullout strength and high re-tear rates after surgery. It is important to assess bone quality in these patients before proceeding with rotator cuff repair and to consider strategies to improve bone health before and after surgery.

Timeline

  • Patient experiences chronic rotator cuff tear, leading to pain, weakness, and limited range of motion in the shoulder
  • Patient undergoes imaging studies such as MRI to confirm the diagnosis and assess the severity of the tear
  • Patient may undergo conservative treatments such as physical therapy, corticosteroid injections, and rest to manage symptoms
  • If conservative treatments are unsuccessful, patient may undergo rotator cuff repair surgery to reattach the torn tendon to the bone
  • After surgery, patient will undergo a period of rehabilitation and physical therapy to regain strength and range of motion in the shoulder
  • In older patients with poor bone quality, additional measures may be taken to improve bone density and optimize the healing process, such as vitamin D supplementation and weight-bearing exercises
  • Long-term follow-up is important to monitor for any complications or re-tears of the rotator cuff

Overall, the timeline for a patient before and after rotator cuff repair involves diagnosis, treatment, surgery, rehabilitation, and long-term monitoring to ensure optimal outcomes and recovery.

What to Ask Your Doctor

  1. How will my osteopenia or osteoporosis affect the success of my rotator cuff repair surgery?
  2. Are there any additional precautions or considerations I should take during the recovery process due to my bone health?
  3. Will my bone quality impact the type of surgical technique or materials used in my rotator cuff repair?
  4. Are there any specific exercises or physical therapy recommendations to help improve my bone quality and enhance the healing process after surgery?
  5. What are the potential risks or complications associated with rotator cuff repair in patients with poor bone quality?
  6. How often should I follow up with you after surgery to monitor the healing of my rotator cuff and bone quality?
  7. Are there any dietary or lifestyle changes I should make to support the healing of my rotator cuff and improve my bone health?

Reference

Authors: Entezari V, Lazarus M. Journal: Orthop Clin North Am. 2019 Apr;50(2):233-243. doi: 10.1016/j.ocl.2018.10.006. PMID: 30850081