For years, Wauwatosa resident Christine Adams-Matt put up with the discomfort she felt in her shoulder. “I had constant pain but it didn’t stop me from doing things,” she said. “I guess I got used to it and couldn’t remember how it felt to feel good.” Then she decided she wanted to know what it’s like to feel good again.
Conservative Treatments First
Christine met with her primary care doctor, Kathleen Sawasky, MD, an internal medicine physician who practices at the Froedtert & the Medical College of Wisconsin Springdale Health Center. Dr. Sawasky started her on physical therapy.
“We usually begin with less invasive measures, and with neck and posterior shoulder pain, physical therapy is the standard initial approach,” Dr. Sawasky said. “With therapy, Christine experienced improvement, but then her shoulder started to bother her more and more.”
Dr. Sawasky had Christine tested for carpal tunnel syndrome, as pain from this condition can extend from the wrist up the arm, but the results were negative. Suspecting a possible rotator cuff tear, Dr. Sawasky ordered an MRI.
“She did have some tearing of her supraspinatus and subscalpularis tendons but not enough to account for the level of pain and decreased range of motion she was reporting,” Dr. Sawasky said.
By this point, Christine had dealt with this issue for almost 10 years. That’s when Dr. Sawasky sent her to see orthopaedic surgeon and MCW faculty member Steven Grindel, MD, who determined arthritis was causing the pain and offered a surgical remedy.
“I wish I could say this was all because I was playing racquetball every day, but I’m not an athlete,” Christine said. “I hadn’t had any injury. I’m a normal, average person just doing day-to-day activities. When Dr. Grindel mentioned shoulder replacement, I was surprised.”
Christine wasn’t ready to commit to surgery, and Dr. Grindel understood entirely.
“This type of surgery is best done when patients feel ready for it,” he said. “I will not tell a patient — unless there was a trauma — that we have to replace their shoulder. Christine decided to live with it and then we saw her again six months later and did X-rays to make sure there was no advanced progression of the arthritis, which there was not. But her symptoms were not a lot better.”
Christine appreciated Dr. Grindel’s approach. “I really liked that he didn’t say I needed immediate surgery,” she said. “I was functioning and accepted the pain. He told me to let him know when it really began interrupting my life. After my second visit, I decided to move forward with a shoulder replacement.”
Shoulder Replacement Surgery
In early summer 2018, a week before her 60th birthday, Christine received a shoulder replacement at Froedtert & MCW Community Memorial Hospital in Menomonee Falls. Her compromised shoulder components were replaced with a prosthetic system.
“Replacing diseased or damaged joints with an artificial joint can offer relief from arthritis, overuse and injury,” Dr. Grindel said. “The new parts allow the joints to move and function again with little or no restriction or pain. Shoulder replacement surgery works well for somebody like Christine, who is relatively young and active and has a functioning rotator cuff.”
A joint replacement is a complicated, precise operation involving nerves, muscles, bones, tendons and blood supply. All aspects of the procedure, including helping the patient prepare, selecting the implant, performing the surgery and planning recovery and rehabilitation, must be handled with the utmost expertise. Statistics show that the more experienced the physician is, the better the patient outcome.
Dara Mickschl, a certified physician assistant, met with Christine before and after her surgery. “We help patients understand their diagnosis and, after examining their goals and lifestyle, come up with a plan that may include physical or occupational therapy, steroid injection or activity modification,” Mickschl said. “As a physician assistant, I also participate in surgeries to understand what has taken place so I can communicate effectively with patients afterward.”
A month post-surgery, Christine was back at work as administrative assistant to the chancellor at the University of Wisconsin-Milwaukee. “I had a great recovery, with good pain management and a really good attitude,” she said.
“She’s doing really well,” Dr. Grindel said. “Six months after surgery, she had excellent return of function and was doing everything she wanted to do. She was working on stretching and was back to the activities she enjoys.”
Christine is happy she was an active participant in choosing her care. “I have a lot of confidence in the Froedtert & MCW health network,” she said. “I knew my shoulder would be taken care of and done right. And I was mentally prepared for the surgery and recovery. For me, the time was right.”