Shoulder. Reverse Prosthesis Surgery. Interview with Prof. Marco Spoliti.

Rotator cuff injuries represent a degenerative lesion and a common cause of shoulder pain: today it is possible to treat them surgically, even in severe cases. To find out more, we interviewed our orthopedist, prof. Marco Spoliti, who is particularly experienced in traumatology and shoulder surgery.

Prof. Spoliti, what are the causes and possible consequences of rotator cuff injuries?

Rotator cuff injuries are a degenerative lesion that can easily be aggravated by some associated conditions such as smoking, hypothyroidism, arterial hypertension, micro traumas related to sports activity, major traumas. It mainly affects patients over the age of sixty. When the rotator cuff lesion occurs in patients under this age it becomes a problem not only functional but also clinical, as young patients must be treated immediately to prevent the aggravation of this lesion, which when chronic, widens over 4 cm in diameter and undergoes a major adipose degeneration, making it impossible to repair the tendon itself and forcing rescue interventions that do not have the same result as an arthroscopic repair of the rotator cuff.

Prof Spoliti in which cases, therefore, is it recommended to intervene surgically?

In younger patients, in recent ruptures, in full-thickness ruptures in order to preserve the shoulder from further degeneration of the tendon and therefore from all those consequences that lead to the non-repairability of a tendon and therefore the need for other more invasive interventions than simple arthroscopy.

In the case of a rotator cuff injury, what kind of surgery do you recommend?

Arthroscopic repair.

When is reverse shoulder prosthesis surgery to be preferred over traditional shoulder prosthesis surgery?

When a degenerated and no longer functioning rotator cuff, broken for a long time, has determined the evolution into eccentric arthrosis that prevents the functioning of an anatomical prosthesis therefore, in these cases, the reverse replacement is necessary that builds a mechanical fulcrum where the biological fulcrum no longer exists.

What are the advantages?

The complete recovery of the joint function of the shoulder.

In terms of duration of surgery and recovery time?

The surgery lasts about an hour and the recovery time is two months.