Congratulations are in order for one of our newest physicians! Dr. Robert Hartzler, orthopedic surgeon and shoulder and elbow specialist, presented his research at the 2015 AAOS Annual Meeting in Las Vegas, NV on March 28th. His paper was also nominated for the Charles S. Neer Award, a prestigious honor which provides “recognition for outstanding clinical investigation contributing to the understanding, care or prevention of injuries to the shoulder and elbow.“
Watch the video of Dr. Hartzler’s presentation on “Risk Factors for Poor Functional Improvement After Reverse Shoulder Replacement for Massive Rotator Cuff Tears” above or keep reading for the summary from Dr. Hartzler:
- Reverse shoulder replacement has been a great advance for shoulder surgeons, but we are still learning when and for which patients to perform this operation.
- The original use of the reverse was for elderly patients with shoulder arthritis and big rotator cuff tears (rotator cuff tear arthropathy).
- Use of this procedure for patients with big rotator cuff tears without arthritis was very shocking to many shoulder surgeons when it was first described, and many surgeons still believe it should not be done.
- Patients with massive rotator cuff tears without arthritis usually have both pain and reduced shoulder function – lack of movement and/or weakness. Our goal in this study was to try to find risk factors for having a specific type of poor outcome after the operation, namely lack of a significant functional improvement.
- In the study we found three independent risk factors for this: a nerve problem causing shoulder weakness, young age, and high baseline function.
- Patients with these risk factors should think very carefully about having a reverse shoulder replacement as they have a high risk of not improving their shoulder function (ability to perform activities of daily living, work, and sports), even though they may experience pain relief from the operation.
- Without caution in patient selection, performing reverse shoulder replacements for rotator cuff tears will result in many patients who are disappointed in their shoulder function.
Dr. Robert Hartzler is an orthopedic surgeon, fellowship trained in surgery of the shoulder and elbow. He treats patients aged 6 years and older and has a special interest in the arthroscopic reconstruction of injuries to the shoulder and elbow. To schedule an appointment with Dr. Hartzler, please call 210.281.9595 or request an appointment online.