Charles A. Rockwood, Jr., MD
Material Covered:
"Interest in the use of the arthroscope in the shoulder joint has been increasing over the past ten years, and continuing education courses on the subject are oversubscribed. While the shoulder arthroscope was first used as a diagnostic tool, in the past five years it has increasingly been used as an operative tool: The attendees of the instructional course lectures of the American Academy of Orthopaedic Surgeons request more and more details regarding techniques of operative arthroscopy in the shoulder. Since the era of operative arthroscopy is evolving, we must ask whether operative arthroscopy is an appropriate method of treatment for patients who have a problem about the shoulder." Charles A. Rockwood, Jr., M.D., editorial: JBJS, June 1988.
One of the most commonly assessed symptomatic conditions about the shoulder is impingement syndrome and associated rotator cuff rupture and/or degeneration. Reported results associated with the use of the arthroscope have routinely shown it to be less effective at relieving symptomatic impingement shoulder problems as compared to those achieved with open operative intervention. Subsequently, open intervention techniques, used for decades for the treatment of impingement syndrome and rotator cuff problems, remain the procedure of choice for a great many orthopaedic surgeons. In this VJO follow-up, shoulder specialist Charles A. Rockwood, Jr., M.D., Professor and Chairman of Orthopaedics at the University of Texas, San Antonio, surgically demonstrates his technique for open acromioplasty and rotator cuff debridement/repair.
Over the past decade, Dr. Rockwood and others have found resultant in their open acromioplasty series that by not removing enough of the acromion distally, patient relief was short-term. As a result, Dr. Rockwood routinely removes the distal acromion in line with the lateral border of the clavicle and undermines the transected acromial end with an angled cut. This technique has provided for excellent results as published in Orthopaedic Transactions 8, 10, and 12.
Considering these findings, Dr. Rockwood correlates the difficulties of efficiently removing adequate amounts of acromion when utilizing the arthroscope. In addition, Dr. Rockwood poses the question, "Can one truly assess associated rotator cuff anomalies noted in 90-95% of all impingement syndrome patients, as first reported by Neer, with the use of the arthroscope, and if so, does the arthroscope offer the surgeon the best access to properly repair it?"
- References
- Rockwood CA Jr. Editorial on Shoulder Arthroscopy JBJS 70-A(5):639-640, June 1988
- Rockwood CA Jr. The Management of Patients with Massive Rotator Cuff Defects by Acromioplasty and Rotator Cuff Debridement Orthop Trans 10:622, 1986
- Rockwood CA Jr., Burkhead WZ Management of Patients with Massive Rotator cuff Defects by Acromioplasty and Rotator Cuff Debridement Orthop Trans 12:190-191, 1988
- Rockwood CA Jr. Shoulder Function Following Decompression and Irreparable Cuff Lesions Orthop Trans 8:92, 1984
Specifications
- Total Run Time: 20:22 minutes
- Catalog Number: 7005
- VJO Publication Date: December, 1988