What Kobe Bryant’s Surgery Means to You!

Kobe Bryant has recently undergone a rotator cuff repair which has ended his 2015 season and may jeopardize his career. The purpose of this blog is to explain the function of a rotator cuff, how it can tear and what the symptoms are and to outline the various treatment options that are possible. Each patient does not have the same physical demands and expectation of function that Kobe must have and each patient must individualize their treatment program based on their own needs and goals.
The rotator cuff is made up of four tendons that blend together and rotate the shoulder. A tendon is a structure that connects muscle to bone and is the pulley that lifts and rotates the shoulder. A tendon can tear from an acute, significant injury like a fall onto the shoulder or dunking a basketball such as Kobe or it can be a chronic, repetitive stress that tears a degenerative tendon such as merely lifting a suitcase.
The tendon is under tension like a guitar string and pulls apart and can no longer function as a shoulder rotator. The patient will complain of pain particularly on overhead activities and weakness to external rotation.
Patients of all ages who develop these symptoms should be seen by an orthopaedic surgeon as the sooner a diagnosis is made the sooner the appropriate treatment can be initiated based on the patient’s age, level of pain and weakness and their own goals and demands.
An MRI (Magnetic Resonance Image) is the diagnostic test that confirms the diagnosis. (A standard x-ray will not visualize the rotator cuff tendon) All insurance companies will pay for this procedure as it is the standard of care.
The problem with rotator cuff tears is that if untreated many progress in size and lead to more pain and more shoulder weakness and loss of function. A number of the tears, however, do not progress and current reasearch protocols are trying to determine which tears progress and which tear should definitely be treated with surgery.
In general younger patients (less than 60) should be treated with a surgical repair as a tear will progress in younger, more active patients. Older patients (greater than 70) can be treated with physical therapy to build up the surrounding muscles to compensate for the torn muscle-tendon joint. Patients between 60 and 70 need to individualize their care based on their symptoms and goals.
The GOOD NEWS is that a surgical repair of a torn rotator cuff tendon is highly successful with results greater than 90% in most studies.
I spent a year studying the surgical repair of the rotator cuff with Frank Jobe, the legendary shoulder surgeon who founded the Kerlan-Jobe Orthopaedic Clinic. The doctors here at the Los Angeles Orthopaedic Institute have performed thousands of rotator cuff repairs and would welcome the opportunity to outline an appropriate treatment for you and your rotator cuff!
Keep Moving!
Dr. Sisto

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About djsisto
Orthopedic Surgeon at the Los Angeles Orthopaedic Institute

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