Summer 2009

Hole in One

Minimally Invasive Rotator Cuff Repair Gets Golfer Back in the Game

David Foggo doesn’t throw a 90 mile-per-hour fastball, can’t throw a football sixty yards and, despite a love of golf, hasn’t yet seen his name splashed across the leaderboard at PGA Tour stops like Pebble Beach or Pinehurst Country Club.

Annapolis lobbyist and golfer David Foggo (L) poses with orthopedic surgeon Charles Ruland, M.D., also a golfer, at the U.S. Naval Academy golf course. Eighteen months out of surgery to repair a massive rotator cuff tear, Mr. Foggo is back on the links.

How, then, did he find himself undergoing arthroscopic shoulder surgery last March to repair a torn rotator cuff and damage to the tendons of his upper arm? After all, most people associated with torn rotator cuffs are major league ballplayers, NFL quarterbacks, or pro golfers, not a devoted golf amateur.

“Last February, we had a big ice storm and, of course, traffic was gridlocked,” said the 61-year-old lobbyist from Annapolis. “I decided to stay at work and just leave a few hours later. Walking to my car around 9 p.m., I stepped right onto a patch of ice and went down like a rock.”

Mr. Foggo, carrying a bundle of mail under his right arm, stuck out his left arm to brace himself, causing his body’s weight to come crashing down onto one critical joint—his shoulder—when he fell.

AAMC emergency room physicians treated a partial shoulder dislocation, but suspected that further diagnostic testing and examination would reveal a torn rotator cuff.

Surgeon Charles M. Ruland, M.D., of Anne Arundel Orthopaedic Surgeons, P.A., examined Mr. Foggo, and ordered an MRI to confirm the suspected rotator cuff tear.

“David’s fall generated a massive, 6-centimeter tear along his rotator cuff,” said Dr. Ruland. “When his shoulder took the weight of his body, he also damaged the tendon that runs along the shoulder blade, and his biceps tendon. When he arrived at my office, he couldn’t raise his arm and was in severe pain.”

With a diagnosis came some positive news: Dr. Ruland performs the type of surgery needed to repair this damage arthroscopically. During an arthroscopic procedure, surgeons insert a tiny camera and surgical instruments through a small incision and view their progress on a television screen. Because the incisions are so small (less than ½ inch), tissue trauma and blood loss are minimized, reducing postoperative pain and scarring. Recovery time is greatly reduced. “Ten years ago,” said Dr. Ruland, “this surgery wasn’t considered feasible.”

Dr. Ruland successfully repaired the rotator cuff tear and mended the tendon damage. Months of physical therapy followed to allow Mr. Foggo back to his golf game.

“I think this surgery actually helped my golf game,” he said. “It’s shortened my swing, and I think has actually made me better.”

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