LEXINGTON — When it comes to medical information, there is a plethora online and most people know about procedures through word of mouth from friends, relatives, etc. Yet not all of it is accurate and people may have misconceptions about procedures
Dr. Thomas Saylor, an upper extremity orthopedic surgeon and specialist from Florida, visits Lexington Regional Health Center once a month. He handles everything from fingertips to the shoulder and has 25 years of experience.
On Wednesday, Feb. 12, Dr. Saylor presented the month’s wellness connection with a focus on rotator cuffs, carpel tunnel syndrome and total shoulder replacements.
A person’s rotator cuff is made up of four different muscles and their attached tendons. Together they assist in stabilizing the shoulder joint as well as in performing various arm movements.
Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury also increases with age, according the Mayo Clinic website.
Dr. Saylor said one treatment for a rotator cuff injury is stem cells, but in his practice he cautions against using them for rotator cuff injuries.
“They are not magic,” Dr. Saylor said, but notes they have been marketed this way. He said there is little objective evidence they will help the injuries he works with. On stem cell use, he simply said, “be cautious.”
When it comes to his treatment for rotator cuff injuries, Dr. Saylor said, “I try to exhaust therapy and injections before moving on to surgery.”
In the past a bone spur was, “inordinately focused on,” when it came to treating pain in the shoulder, Dr. Saylor said, but now it is known injury to the rotator cuff should be the focus of a doctor’s attention.
He told those in attendance not to believe the hype about how painful injections can be, he added people have this horrible fear about them but in most cases it is not warranted.
Only around 15 percent of patients he sees need surgery, Dr. Saylor said.
Many people, when they know they have a rotator cuff injury, will immediately assume an MRI scan is in order, but Dr. Saylor said in most cases it is not necessary and has been overused. In his practice, he uses an MRI scan for pre-operation planning for surgery.
Dr. Saylor has been asked often if a rotator cuff injury will heal on its own, he said partial tears of the tendon can heal to a degree, but a full tear will not heal, the pain may fade, but the restriction of motion will always remain.
When it comes to surgery for rotator cuffs, Dr. Saylor said the bottom line is six months to a year of recovery is necessary. He said not to believe anecdotal stories about quicker recoveries, the proper time to regain motion will take time.
The first six weeks the arm will be in a sling, the next six weeks the person will start to regain some motion and after that, more full motion recovery takes place.
Physical therapy after this type of surgery is so important; Dr. Saylor said he will not operate on people who will not have access to it afterward.
When it comes to recovery time, dealing with carpal tunnel syndrome is much easier and less invasive than in the past, said Dr. Saylor. A small incision is made on the hand and through this, motion can be restored. Cubital tunnel, is the second most common and occurs in the elbow and is handled in the same way.
While it’s more invasive, a total surgery replacement’s recovery time is actually faster than a rotator cuff surgery, only requiring up to two nights in the hospital, with a patient gaining back motion the night after the surgery.
Dr. Saylor said the procedure results in the “highest patient satisfaction,” of any surgery he performs.
Physical therapy immediately follows these types of surgeries; patients are moving their arms as soon after the procedure as possible.
Dr. Saylor visits LRHC once a month, to schedule an appointment with Dr. Saylor, call 308-324-8343.