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Thanks to all who have commented here. I didn't even know what a SLAP tear was.
I have a severely arthritic left shoulder. I guess "severe" is relative because I can still do a lot and I'm in the gym everyday. I just know it's not gonna get better and I'll need a replacement, hopefully not a reverse. I don't think my rotator cuff is damaged and I have good range of motion. But some nights it hurts like hell even when I don't sleep on that side.
I have heard more success stories from shoulder replacement patients than from patients who have had surgery to repair a RC, or is this case, a tear in the cartilage lining (SLAP). I don't have any cartilage left so there is nothing to tear. Call me lucky I guess.
I just don't understand why, in general, surgery on soft tissue in the shoulder is so difficult to treat successfully. Does anyone have any insight into this?
I'm 70 now, very fit fortunately and have had both knees replaced, left hip scheduled for March and left shoulder on deck. I'm just baffled that a TSR or RTSR seems to generate fewer post-op complaints than surgery on soft tissue in the shoulder. Any insight is greatly appreciated.
(And I suggest doing whatever it takes, and waiting as long as it takes to get a good surgeon. My criteria, FWIW, are doctors in their late 30s to late 40s with a solid med school pedigree and/or residency at a prestigious facility (Mayo or Cleveland Clinic). These surgeons are still young and ambitious, current on best practices, and have done hundreds if not thousands of procedures. Hope that helps, and all the best to my fellow shoulder sufferers. I sincerely wish you all the best. Joe)
Replies to "Thanks to all who have commented here. I didn't even know what a SLAP tear was...."
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Hi Joe, well, you asked a question I am very curious about, since I have several repairs in the healing stages now after rotator cuff surgery, "...I just don't understand why, in general, surgery on soft tissue in the shoulder is so difficult to treat successfully. Does anyone have any insight into this?"
You must know by now know that I am sort of a research nerd, and I did look into this before I proceeded with surgery.
Here is an excellent paper on the issue:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7307866/
One of the most informative paragraphs says: "...In cases of extra-articular tendon and ligaments that have the capacity to heal, the surgeon will reconnect or re-attach the torn tendon and ligament. These procedures usually result in the formation of inferior scar tissue which is more prone to re-rupture..."
The entire paper is more discussion about emerging knowledge of how ligaments and tendons repair themselves (not very well - lots of scar tissue) and advances in stem cell and adjunct therapies (still in early stages.)
I had a donor grafted ligament inserted in my knee nearly 40 years ago (I did not have a suitable one of my own) and the surgical understanding at the time was that it would "probably" last 15 years or so. But, the surgeon recommended early complete rest (6 weeks) to allow the healing to begin, followed by long, progressive PT and strengthening (almost 6 months.) Now in my 70's that knee is still going strong.
Recently, I had complex rotator cuff & biceps tendon repair, along with debridement of many bone spurs, done by a highly recommended surgeon. His healing protocol is similarly strict, with immobilization for 6 weeks, and no PT except very basic mobilization exercises until 8 weeks, to allow time to heal. In addition, according to the Doctor of Physical Therapy I am now seeing, his PT approach is "beyond ultra-conservative." But, unlike the typical 30-50% failure rate for rotator cuff surgery, his is below 10%. So at 4 months, I am just beginning to push my range of motion, and strengthening is done with isometrics and no weights. The DPT is not convinced this is a good protocol, but he says "we can't really with his success rate."
So I am very hopeful that this conservative approach is allowing for proper healing of the repaired tendons. I do know that the enforced rest has allowed healing of some of the tears in my trapezius and pectoralis muscles.
Just as an aside - other soft tissue tears such as the labrum in the hip are equally resistant to successful surgical repair.
Good luck with you hip - mine are still dong great after almost 14 years - I think my knees might be next up, but I am trying for a surgery-free year in 2025.