Achilles grafted into shoulder

June 4, 2004

I hadn't seen this in my searches before; thought I would pass it along.

January 26, 2000 Volume 36 Issue 04

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By Myron Love

Winnipeg surgeon performs 'first' soft tissue transplant in Canada

WINNIPEG - Orthopedic surgeon Dr. Mac has performed what may be

the first soft tissue transplant in Canada.

Last November, the Winnipeg surgeon transplanted an Achilles tendon he

acquired from an American tissue bank into Winnipeg teenager Jeff Grantham's

right shoulder.

Grantham suffers from a rare and progressive hereditary condition called

Ehlers-Danlos syndrome (EDS) which afflicts one in 5,000 people.

It is caused by an abnormality of collagen and mainly affects the connective

tissue that joins skin to bone. Grantham has to wear braces on all his

joints to keep them in place.

" Jeff has problems all over, but his right shoulder was the worst, " said Dr.

Mac.

" I had operated on it four times without success. "

It was actually the patient who suggested the new approach. While attending

an EDS conference in Philadelphia, he met Dr. Joe Iannotti, the shoulder

specialist who pioneered the surgery.

" Dr. Iannotti uses a different technique involving fascia lata grafts, " said

Dr. Mac. " I decided to try it with an Achilles tendon. "

He put the boney end of the tendon on the anterior glenoid, divided the

tendon into strips and pulled the strips over to the humeral side to

recreate the shoulder ligaments.

Thus far, Dr. Mac said, the surgery seems to have been effective in

keeping the shoulder from falling out of place.

Up to now, the treatment for EDS has been to stretch the ligaments ever

tighter to keep joints together. In extreme cases, surgeons will fuse joints

shut, and sufferers can end up in a wheelchair.

While Dr. Mac sees other EDS sufferers, he is not at present

considering transplants for any of them.

" The other cases I have seen are not as severe as Jeff's, " he said.

" Transplants remain an option for the future though. "

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