Orthopedist with Specialty in Shoulder Surgery Joins MUSC Health Lancaster

Residents of Lancaster and the surrounding communities don't have to leave the area for expert orthopedic care.

Dr. Marcus Briones, an orthopedic surgeon who specializes in upper-extremity (shoulder) surgery, and treatment for elbow, wrist, and hand problems, provides advanced orthopedic care at MUSC Health-Lancaster. He joined the MUSC Health system in January.

Named one of Charlotte Magazine's Top Doctors in 2021, Dr. Briones says he was drawn to MUSC Health Lancaster by the opportunity to provide university-level care in a community setting.

"I trained at MUSC, and when this position became available, I saw there was a need here and an opportunity to bring great care to this community," says Dr. Briones, who is fellowship-trained in upper-extremity surgery.

Rotator cuff tears are among the conditions for which he provides a full spectrum of treatment, from physical therapy, injections, and anti-inflammatory medications to arthroscopic surgery techniques for patients who have not responded to conservative treatments.

Rotator cuff tears are quite prevalent, he says. Although trauma and athletic injuries can cause rotator cuff tears, the natural aging process accounts for most tears, particularly as adults reach their 50s and 60s.

"Rotator cuff tears are more the result of a degenerative process rather than something that happens through trauma," Dr. Briones says. Moreover, such tears are stealthy. Of patients over 60, one-third don't even know they have a tear; only 5% are symptomatic."

Symptoms include shoulder pain that interferes with daily activities and sleep. “Night pain that disrupts sleep is what prompts patients to seek medical care," he says.

When a patient complains of shoulder pain, Dr. Briones obtains a thorough medical history, performs an exam, and does an x-ray. He recommends physical therapy and/or medications such as non-steroidal injection or anti-inflammatory medication to break the inflammatory cycle.

"I give that time to work - about 4 to 6 weeks. If pain persists, that's when we do an MRI, which can show whether there's a partial tear of full tear," he says.

Dr. Briones offers several options for patients who failed conservative measures tailored to the patient's diagnosis. All are done arthroscopically, minimally invasive surgery through an incision no bigger than the end of a pencil.

For less severe tears, Dr. Briones places a collagen patch slightly bigger than a postal stamp over the partial tears. The collagen promotes healing and growth of new tendon. Study results show favorable outcomes. "In 95% of patients, the rotator cuff heals completely or partly, and patients can return to their normal activities more rapidly," Dr. Briones says. "The 6-month data show that the patch is absorbed by the body, which actually forms new tendon."

The procedure, which takes about an hour to 90 minutes, is outpatient and performed under general anesthesia with a nerve bloc. Patients must participate in physical therapy. "This is a definitive treatment, meaning no secondary surgery is needed," he says.

For patients who have full rotator cuff tears in which the tendon is no longer attached to the bone, he sutures the tendon back to the bone to promote healing. "Patients must keep their arm in a sling and participate in physical therapy for several months. This procedure also takes about 90 minutes.

For bad tears, Dr. Briones offers a reconstructive option in which he places a dermal (skin) graft between the shoulder socket and the top of the shoulder. Called superior capsular reconstruction, the technique helps restore range of motion and is an option before considering shoulder replacement.

The human dermal allograft (tissue from another donor) is measured and cut precisely during the procedure, which takes about two and a half hours and is performed under general anesthesia with a nerve block.

For rotator cuff arthropathy, a torn rotator cuff that cannot be repaired and is characterized by intense pain and severely limited motion because of arthritis, Dr. Briones offers total shoulder arthroplasty. Also known as total shoulder replacement, the surgery restores range of motion and decreases pain. He performs a reverse total shoulder arthroplasty, which restores more range of motion and provides more pain control.

Dr. Briones treats patients of all ages with elbow, wrist, and hand problems.

"My practice runs the gamut," he says, "and I'm pleased to provide the full range of patient-centered orthopedic care in a community setting. MUSC Health is leading the way in community care in our state, and I'm proud to be part of their endeavor to improve health care in South Carolina."

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Dr. Briones is accepting new patients at his practice, located at 1025 West Meeting Street, Suite 100, Lancaster, SC 29720. To make an appointment, call 803-285-3700.