TSR Surgery and Rotator Cuff Sparing

[holly77]

Do any of the members have experience with the so called minimally invasive technique of total shoulder replacement developed by Laurent Lafosse? In this outpatient technique, the rotator cuff is spared, while in traditional TSR, the rotator cuff is cut. My rotator cuff is still intact, so it would be nice if this was an option. So far in my research, I have located 3 surgeons in OH, CA, and WA who are performing these. There may also be some at the HSS in NY, but I haven't inquired yet. If anyone has had good results with this surgery, please let met know. I may need to travel out of state, as the surgeons I am consulting with in my area only do the traditional total shoulder replacement. Thanks!



2013 traumatic injury to rt. glenoid/humeral joint
Superior Labrum Anterior and Posterior grade 3 diagnosed
Proposed treatment arthroscopic repair
2014 arthroscopic "repair" performed, with PRP, debridement, & subacromial smoothing
Labrum tear downgraded to 1 during surgery
No history of shoulder dislocation or any pain prior to 2013 injury
MRI, plane bi-lateral x-rays 4-2017 show severe D.A. rt shoulder/ none in left
2017 recommended treatment tsr for rt. shoulder
High levels of pain 24/7 and limited ROM

Holly77, 9-2017

 

[Josephine]

I've never heard of the gentleman though I would imagine he's pretty 'up there' in the shoulder surgery stakes. But to be honest, I cannot conceive how they can perform a shoulder arthroplasty without division of at least one of the 5 rotator ligaments.

 

[holly77]

I'm researching this now, but to my knowledge it is possible to perform a TSR without cutting any of the 4 rotator cuff muscles, (supraspinatus muscle, the infraspinatus, teres minor, and the subscapularis). Beyond that, there may be a need to cut ligaments...I will find out. The first surgeon we spoke with was going to cut though one of these 4 muscles, which would make recuperation time much longer.

 

[Josephine]

Why I said that was because the shoulder is a very tiny joint and the rotators are actually very short and strong muscles. I can't even imagine trying to retract them to prepare for and insert a joint replacement. It would be like trying to operate inside a small hen's egg without cracking the shell!

 

[holly77]

I spoke with the PA for one of the top orthopedic surgeons in the US today in Houston. He confirmed to me that a TSR can be done without cutting into the RC muscles and ligaments. Apparently the surgeon does, in fact, retract the muscles to insert an artificial joint. He does about 4-6 surgeries/ per week. I have also confirmed this type of surgery was performed for one of neighbors who had TSR several years ago in Washington state. His RC was spared and also his recovery time. Today he plays golf and is quite good. I will continue to research this type of surgery as long as my RC is intact.

 

[Josephine]

oh, okay! Learn something new every day time!