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As a welder, Lazaro Gonzalez is no stranger to the toll of physical labor.
So, when a sharp pain went through his shoulder while performing a task at work, Gonzalez didn’t give it too much thought. When the pain persisted, the Joliet man chalked it up to arthritis and took medication to help with what he thought was just inflammation.
Then he noticed a lump on his arm and gradually became unable to lift his arm overhead.
“Every time I touched it … it would hurt,” recalls Gonzalez.
An MRI showed a massive rotator cuff tear, in particular the supraspinatus, the most commonly injured rotator cuff tendon, showed signs of severe atrophy.
This was consistent with an acute-on-chronic injury, meaning that Gonzalez had compensated for a prior injury to the shoulder many years prior and his most recent injury made routine rotator cuff repair surgery impossible. Because Gonzalez was a young, active 50-year-old, shoulder replacement also was not a viable option as it would limit the range of movement and weight bearing of his right arm and would likely require another surgery within his lifetime.
“In the past, there wouldn’t have been any good treatment options for him,” says Zahab Ahsan, M.D., an orthopedic surgeon with Edward-Elmhurst Medical Groups-Orthopedics, noting that physical therapy and medications to manage pain would’ve been the standard course of care.
But now a novel surgical procedure is helping patients like Gonzalez.
Superior capsular reconstruction (SCR) uses a dermal allograft to help rebuild the shoulder rotator cuff.
“More and more shoulder surgeons are learning this technique (SCR) to help treat our patients who didn’t previously have a solution,” says Dr. Ahsan, whose fellowship in shoulder surgery and sports medicine at the world-renowned Hospital for Special Surgery in New York City included performing this particular procedure.
A dermal allograft, measuring just 30 mm (millimeters) x 45 mm, was attached inside Gonzalez’ shoulder muscle via arthroscopic surgery that took about four hours. Once attached to bones making up the shoulder joint, the dermal allograft helps the rotator cuff regain function as it supports muscle and tendon growth around the allograft.
The November 2020 surgery, however, was just the beginning, says Dr. Ahsan, adding that recovery involves extensive physical therapy. For many shoulder surgery patients, physical therapy can last six to nine months, or longer.
Now into his sixth month of physical therapy, Gonzalez, whose work often involves overhead welding, is working on regaining enough strength to be able to lift heavy tools overhead.
Prior to surgery, he rated his pain at a seven and was unable to even lift his right arm over his head. Today, he says he has no pain and is able to easily lift his arm above his head. He returned to work, on light duty, in March 2021.
“I’ve been noticing that the movement of my arm is a lot better,” says Gonzalez.
There’s still work to be done for him to get back to regular on-the-job duties, but Gonzalez is committed to his physical therapy sessions and at-home exercises.
“We’re in the process of strengthening,” says Janelle Smith, PT, Gonzalez’s physical therapist, saying that his dedication to his therapy has played a big role in his recovery.
For Dr. Ahsan, being able to offer Gonzalez a chance to regain function of his arm after this devastating injury has been very rewarding.
“I tell my friends and family that I have the best job in the world because I can help people in a way that provides immediate impact to their quality of life,” he says. “It is truly gratifying.”
The orthopedic team of experts at Edward-Elmhurst Medical Groups-Orthopedics provides exceptional orthopedic, sports medicine and podiatry services for patients of all ages. We use the least invasive treatments necessary to help you get back to the activities you enjoy, as quickly as possible. Learn more.
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