Patient Story: Peter Gori

For patient Peter Gori, and others whose livelihood include physical activity, the occasional body aches and soreness are part of the job. Peter owns a landscaping business and therefore relies on his body to get the jobs done. But when that pain worsens, making movement difficult, it is time to seek professional help.

“I was never a ‘sit-down’ boss. My line of work causes me to rely on my body,” explained Peter, who was recently injured on the job. “I knew right away that I did something to my left shoulder, when I lifted a wheelbarrow filled with heavy debris.”

Peter is no stranger to shoulder or knee pain or Dr. Vitolo, who performed surgery on both Peter’s right shoulder and right knee in the past.

“When I tore the ACL in my right knee I met with Dr. Vitolo for a second opinion. After talking to him, I trusted him right away,” said Peter.

“Now after these surgeries, I wouldn’t trust anyone else. He is a phenomenal orthopedic surgeon who goes in and gets the job done.” 

 After an MRI showed significant injuries to his left shoulder, surgery was performed on May 10^th. However, the damage was worse than expected. He had three tendons that were damaged: two rotator cuff tendons and the biceps tendon. Peter continues to recover and is hoping for the best.

Q & A with Dr. Vitolo

Prognosis

“Due to the amount of damage his prognosis was guarded. But Pete could not do his job or resume his active lifestyle with the current injury he sustained.” 

 What pain can be expected following surgery?

“Initially it can be significant, but after the first few days it typically becomes manageable. 

 What after care is expected?

“Usually physical therapy for 8-12 weeks. However, because of the size of Pete’s tear, his physical therapy will be longer.”  

 Who is prone to a torn rotator cuff?

“Individuals who perform repetitive lifting like landscapers and laborers, or those who perform overhead jobs such as electricians and carpenters.  People active in weight lifting and other overhead sports such as, tennis and throwing may also experience such injuries.” 

 How common are rotator cuff tears?

“There is a one in twenty chance of rotator cuff tears in the general population. The incidences of rotator cuff tears is increasing in women.” 

 Can rotator cuff tears be prevented?

“There is no known preventive measures other than not doing the activity.  However, Pete’s surgery went well in part because he was in good physical condition to start and he has a positive attitude toward his recovery.”

 Importance of a positive attitude

“Pete was determined to get better. He owns his own business, which depends on his mobility so he was highly motivated. In addition, his desire to remain active and involved in sports and coaching also contributed to his determination to get better.  

 This is Peter Gori’s third operation performed by Dr. Vitolo. According to the doctor, with each surgery Peter has exceeded expectations from his surgery, namely a faster recovery as well as better –than- expected function after such a severe injury.

“Over 90% of the time the surgery is successful in restoring function and decreasing pain,” added Dr. Vitolo.

Peter’s right knee and right shoulder are now pain free. He hopes for the same outcome for his left shoulder. He expresses his gratitude for the surgeries Dr. Vitolo performed and believes the doctor’s skill is the reason for his successful surgery and recovery.

“I feel ahead of the game because of the work Dr. Vitolo does. He is a true professional, said Peter. “He put me back together and allowed me to resume my life. It has been life changing and I am very grateful.”

Injury Prevention: Little League Pitch Counts and Rest

© sherrie smith | Dreamstime Stock Photos

We have discussed pitch counts and injury prevention for our young athletes in the past, but with baseball season upon us, it is important to remind parents and athletes of the guidelines. Young athletes feel invincible and feel injury "won't happen to them". As a physician with over 20 years of experience in sports medicine, I can assure you that injuries can and do happen. Luckily, some simple precautions can help minimize injury risk.

It is important to mention that while the old adage “practice makes perfect” is true, our youth need guidance in order to prevent injury. Overuse injuries in school aged athletes are on the rise. The incidence of shoulder and elbow injuries among youth baseball and softball players is five times greater than it was in the year 2000.[i]

Many of these baseball injuries are preventable. In recent years, Little League Baseball has released guidelines and enforced regulations to help prevent injury in young athletes (see charts below). The league has put limits on pitch counts during games and also enforced required rest periods. All the guidelines are based on the age of the athlete.

While the guidelines from Little League Baseball are important, there are additional steps that can be taken at practices and off the field.

Here are some tips:
1. Always warm up – stretch, jog and begin with some easy, gradual throwing
2. Try different positions – different positions require the use of various muscle groups
3. REST – don’t play year round and allow rest between games
4. Focus on your form, accuracy and control
5. If you have shoulder or elbow pain, do not pitch
6. Talk to your parents and coaches about any pain – do not play through the pain!

Getting kids involved in sports at an early age is a great idea, but it is important to remember an injury can end their baseball career too soon. By following the suggestions outlined here, injury can be avoided and a lifelong love of baseball and activity can be built!

Case Study: Repeated Shoulder Dislocations and the Latarjet Procedure

Recently, we had an interesting case with a young man in his early 20’s. The patient had dislocated his shoulder “100 times” following a previous surgery (anterior labral repair) performed by another physician. Shoulder dislocation is not only painful, but debilitating. The patient stated that any movement would cause the shoulder to dislocate – even in his sleep. 

A CT Scan was performed to look at the structure of the shoulder bones and revealed that the glenoid bone (the socket of the shoulder) was missing (see pictures). The repeated dislocations likely caused the loss of the front of the glenoid bone. If not repaired, the shoulder would continue to dislocate. 

Normal Glenoid

CT Scan of Missing Bone on Glenoid

In this case, we opted to perform an open surgery known as the Latarjet Procedure. The Latarjet procedure was first performed in France by a French surgeon, Michel Latarjet. The procedure has excellent success rates in patients with recurrent dislocations and recurrence of injury is low. 

In the Latarjet procedure, a portion of bone is taken from scapula (shoulder blade) called the corocoid. The corocoid is a hook of bone located in the front of the shoulder blade. In the Latarjet procedure the corocoid is removed from the scapula, with the muscles still attached. The corocoid is then screwed into the shoulder socket where it replaces the lost bone (see picture below). The attached muscles are then secured to offer support in the front of the shoulder. 

In this case, the surgery was a great success. The patient was in a sling for 4 weeks following surgery to protect the repair. He then performed physical therapy 3x/week for 16 weeks and is no longer dislocating his shoulder. The patient is very happy with the results. 

Latarjet Repair - Bone restored to prevent dislocation

John Vitolo, MD is a board certified orthopedic surgeon specializing in injuries and conditions of the shoulder and knee. With over 25 years of experience, Dr. Vitolo is an expert in the field. To make an appointment, please call 973-300-1553 or visit advocareorthosportsmed.com to learn more.