Washington People: Ken Yamaguchi

Ken Yamaguchi, MD, the Sam and Marilyn Fox Distinguished Professor of Orthopaedic Surgery at Washington University School of Medicine in St. Louis, fixes shoulders and elbows. Although many think of rotator cuff tears affecting athletes, almost 50 percent of people over age 70 have rotator cuff tears, either with or without pain.

Cigarette smoking impedes tendon-to-bone healing

Copyright The Journal of Bone and Joint Surgery. Used with permission.Increased cell proliferation in the saline solution group (B) compared to the nicotine group (A)Orthopaedic surgery researchers at the School of Medicine have identified yet another reason not to smoke. Studying rotator cuff injury in rats, the research team found exposure to nicotine delays tendon-to-bone healing, suggesting this could cause failure of rotator cuff repair following surgery in human patients. This study, the first to evaluate the effects of nicotine on rotator cuff repair, found that inflammation persisted longer in the shoulder joints of rats exposed to nicotine. The researchers also noted less cellular proliferation and decreased collagen production, indications of poor healing.

Cigarette smoking impedes tendon-to-bone healing

Copyright The Journal of Bone and Joint Surgery. Used with permission.Increased cell proliferation in the saline solution group (B) compared to the nicotine group (A)Orthopaedic surgery researchers at Washington University School of Medicine in St. Louis have identified yet another reason not to smoke. Studying rotator cuff injury in rats, the research team found exposure to nicotine delays tendon-to-bone healing, suggesting this could cause failure of rotator cuff repair following surgery in human patients. This study, the first to evaluate the effects of nicotine on rotator cuff repair, found that inflammation persisted longer in the shoulder joints of rats exposed to nicotine. The researchers also noted less cellular proliferation and decreased collagen production, indications of poor healing. More…

Rotator cuff repair with smaller incisions and sturdier stitches

Strong stitches attach the rotator cuff directly to the shoulder bone.Each year in the United States, nearly 300,000 people have surgery to repair their rotator cuff. The rotator cuff is made up of several muscles that allow us to lift our arms or to rotate them during sports activities such as golf, tennis and swimming. The rotator cuff also is used during lifting, washing windows and working in the garden. In the past, surgical correction of the rotator cuff involved an incision through the deltoid muscle on the outside of the shoulder, a lot of pain for weeks after surgery and a long period of recovery. But Washington University orthopaedic surgeons have begun using a minimally invasive system that eliminates the need for the incision through the muscle and limits the amount of post-operative pain. The system allows surgeons to strengthen the repair with a suturing device that sews the muscle right into bone where it can heal more quickly, with less pain.