Shoulder surgery after 60: What older adults need to know
When it comes to shoulder surgery, the approach is not one size fits all.
Earl Brewley, MD, is a shoulder and elbow surgeon with Salem Health Orthopedics. Dr. Brewley says he talks with his patients to figure out if surgery is the best tool, and age and activity level are key factors to consider.
“I like to tailor the patient’s care based on a personalized approach: What’s your activity level, how does it affect your quality of life, rather than it just being an acute or chronic shoulder problem,” he said. “What is your lifestyle? Are there any activities you would like to do that are inhibited by your shoulder ailment?”
A range of reasons can bring patients into Dr. Brewley’s office for this conversation.
Rotator cuff tears and arthritis
“Oftentimes, we see rotator cuff tears, both degenerative and traumatic,” he said. “We also see a fair amount of arthritis. And we’ll see things like frozen shoulders.”
The shoulder surgeon said conservative treatment is usually the first line of defense. That includes ice, oral inflammatory medications, stretching and physical therapy. Sometimes, cortisone injections can be helpful.
If patients are still struggling to put their hands behind their backs or put a seatbelt on, surgery is the next thing to consider.
Surgery and recovery
“For rotator cuff tears, I always let patients know that it’s going to be six months to one year until they feel like they did before the injury,” said Dr. Brewley.
Sometimes a shoulder replacement is the best fit for a patient with arthritis and debilitating motion.
“If someone has arthritic shoulder pain but good motion, surgery could lead to significant improvements in motion while relieving the pain,” said Dr. Brewley. “Those are the reasons why it really depends on how the shoulder pain affects their quality of life.”
The shoulder surgeon said the treatment plan will always start with an open dialogue.
“I want patients to decide based on who they are,” said Dr. Brewley. “We personalize the treatment.”
Orthopedic care
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