Freeing Patients from Shoulder Pain

The following was submitted by Dr. Michael Gott from White Plains Hospital
Often when a patient hears the words “shoulder replacement,” they fear it means a loss of shoulder mobility for months and a long rehabilitation. Not so, assures Dr. Michael Gott, an Orthopedic Surgeon in the Center for Orthopedics and Spine Surgery at White Plains Hospital.

“Because it is not as common as knee or hip replacements, the misconception arises that this surgery entails removing and reattaching bones, tendons, and muscles,” he says. In fact, the procedure is technically a shoulder resurfacing, replacing just millimeters of damaged arthritic bone. During the procedure, Dr. Gott, guided by a CT scan, makes a tiny incision in the upper arm to insert a smooth titanium-alloy implant.

“CT-guided shoulder resurfacing is life-changing for those with end-stage shoulder arthritis, where the cartilage has worn away to create painful bone-on-bone friction,” says Dr. Gott.

Many of the patients the surgeon treats have had prior surgeries, multiple shoulder dislocations or just significant arthritis. Heavy lifting on the job or at the gym can exacerbate the pain. Some patients can no longer even lift their arms all the way up. These patients have exhausted all other options before electing to have the surgery.

“Injections only work for a few weeks or months, and medications have their own side effects,” Dr. Gott says. “And while physical therapy can be helpful for certain shoulder issues, it doesn’t address the damage to the joint that characterizes arthritis.”

For patients hesitant to embrace the idea of resurfacing, Dr. Gott points out the following advantages:

OUTPATIENT PROCEDURE. The patient receives local nerve blocks to numb the affected shoulder, undergoes an hour-long procedure, then receives a sling and returns home the same day. “Shoulder resurfacing requires fewer pain medications and a shorter recovery than even arthroscopic rotator-cuff repairs,” he explains.

MINIMALLY INVASIVE. Technological breakthroughs allow for tiny incisions and implants, removing a slice of bone that can fit on a fingernail. Rather than force metal into the bone, Dr. Gott slides titanium implants close to the joint.

PRECISION APPROACH. Dr. Gott’s team often creates 3D-printed models of a patient’s shoulder in advance to guide their approach during the procedure. “Studying the model cuts down on operating time and enhances accuracy. This focus on precision makes our outcomes even better,” he says.

RAPID RECOVERY. “As soon as they start physical therapy, patients tell me that they see a noticeable improvement in their strength and ranges of motion. They are also sleeping better within weeks, as opposed to months,” he notes. Following the procedure, patients typically require three months of supervised physical therapy, followed by exercises performed on their own as needed. They can then return to non-weight-bearing physical activities, such as golf, tennis, pickleball and racquet sports.

LOGISTICAL EASE. “Patients receive their consultations, CT scans, surgery, and follow-up care in the same location at our state-of-the-art Center for Advanced Medicine and Surgery,” Dr. Gott says. In addition to convenience, getting to know the care team promotes peace of mind for patients.

In the end, Dr. Gott’s patients say they are grateful to have shrugged off their anxiety. “The most common feedback I hear from patients is that they only wish they had done the procedure sooner,” he says. “They not only recover — they bounce back even better.”

Dr. Michael Gott Dr. Michael Gott is an orthopedic surgeon at the Center for Advanced Medicine and Surgery in White Plains. To make an appointment, call 914-849-7897.

Health Matters: The original version of this article was published in Health Matters, a White Plains Hospital publication.