Biologic Tuberoplasty

Biologic tuberoplasty most commonly treats massive irreparable rotator cuff tears. These tears are often seen in patients who have experienced long-term tendon damage, chronic shoulder wear and tear, failed previous rotator cuff surgery, or injuries that caused severe tendon retraction.

Patients with this condition often experience ongoing shoulder pain that interferes with sleep, exercise, work, and normal daily activities. Many people struggle to lift their arm overhead, reach behind their back, carry objects, or do simple tasks such as getting dressed or putting items into a cabinet. Night pain is especially common with large rotator cuff tears. Some patients find it difficult to sleep on the affected side because of the pressure and inflammation within the shoulder joint.

Before surgery is considered, many patients try physical therapy, anti-inflammatory medications, corticosteroid injections, rest, and activity modification. Biologic tuberoplasty may be recommended for patients who still have reasonable shoulder movement but continue to experience pain despite nonsurgical treatment.

The procedure may help patients with:

• Massive rotator cuff tears that cannot be repaired
• Chronic shoulder pain from rotator cuff damage
• Failed previous rotator cuff surgery
• Shoulder weakness and painful movement
• Early shoulder joint wear caused by rotator cuff disease
• Patients trying to delay or avoid shoulder replacement surgery.

Not every patient with a rotator cuff tear is a candidate for biologic tuberoplasty. Patients with advanced arthritis, severe stiffness, or major loss of shoulder function may require other surgical options.

Biologic tuberoplasty is usually performed arthroscopically through small incisions, using a tiny camera inserted into the shoulder joint. Arthroscopic surgery allows the surgeon to treat the shoulder with less disruption to surrounding muscles and tissues. The procedure is typically performed under general anesthesia, and most patients go home the same day after surgery.

The surgery begins with an arthroscopic examination of the shoulder joint. Dr. Waterman carefully evaluates the rotator cuff tear, cartilage, surrounding tendons, and other structures inside the shoulder to confirm that the tendon cannot be repaired adequately.

The surgeon may remove inflamed tissue, damaged tissue, or bone spurs to improve movement and reduce irritation within the joint. Then Dr. Waterman prepares the top portion of the arm bone where the graft will be placed. The biologic graft is carefully positioned and secured using surgical anchors and sutures. Once in place, the graft creates a protective layer between the arm bone and the acromion bone above it. As the shoulder moves, the graft helps reduce painful friction and pressure inside the joint. This cushioning effect can improve comfort and allow smoother shoulder motion.

In some cases, Dr. Waterman may also perform additional procedures during the same surgery depending on the condition of the shoulder. This may include cleaning damaged tissue, treating the biceps tendon, or repairing portions of the rotator cuff that are still repairable.