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Rotator Cuff full tear and retraction of supraspinatus tendon

Posted by jerseyjames @jerseyjames, Oct 28, 2022

General consensus for a senior non-athlete seems to be to give physical therapy a good hard try before jumping into surgery. Thoughts & experiences? Jim

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jlr0285 | @jlr0285 | Mar 19 7:40am
In reply to @waltwhipple "Ruptured, retracted, and inoperable right-side supraspinatus tendon. Orthopedists put me off for three months without any..." + (show)
@waltwhipple

Ruptured, retracted, and inoperable right-side supraspinatus tendon. Orthopedists put me off for three months without any evaluation despite some pain. Then one tried to reconnect with a surgical clip. That failed and he tried again with another clip. Again failure attributed to failure of blood supply to the tendon and conclusion that the rupture was inoperable short of a shoulder replacement. Can't touch my left shoulder blade with fingers of my right hand and cannot lift my right arm above horizontal direct to the side although I can do so passively using a pole. My advice to anyone with a shoulder injury is to get immediate evaluation by an orthopedist even if you must travel elsewhere. Once the blood supply is compromised there is little that can be done. PT is almost useless until you have an uncompromised supraspinatus tendon.

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I’m sorry you have not had success with previous surgeries. If they say it can’t be repaired then you need to go to MGH and see Dr. Elhassan (formerly of Mayo). He’s worked on my shoulder several times when other surgeons wouldn’t touch it. Besides being an incredible surgeon he’s a wonderful person.

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amywood20 | @amywood20 | Mar 20 7:49am
In reply to @mrsflutterby "Hi all, Had a follow-up MRI after some pain in my shoulder that a shot of..." + (show)
@mrsflutterby

Hi all,
Had a follow-up MRI after some pain in my shoulder that a shot of cortisone really helped. (If you read my posts above I had 3 tendons repaired in Nov 22, am still in PT but without pain and have total ROM) I'm so sad and shocked to say that my supraspinatus tendon has come completely apart since being repaired. I've been so careful and dedicated to PT but the doc said I did nothing wrong, that sometimes the tendons just shred. So now I have a total rotator and long head bicep tears that will stay that way unless I have pain or can't sleep. The doc is having me focus on the deltoid muscle group and to strengthen it as much as possible for best ROM. This really knocked the wind out of my sails. I was so sure I was doing everything correctly but sometimes, life just happens. The doc mentioned that if and when the pain comes back or I can't sleep with it, I may need to have a reverse shoulder procedure. Does anyone know what that involves? Have had it? Good/bad recovery? Thanks in advance.

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@mrsflutterby Under the circumstances, I'm surprised they did a cortisone shot. Cortisone can weaken tendons. I have a full thickness tear in my right shoulder and have for five years. It's holding and not getting worse. I do not plan to have surgery at this time. I do know that the surgeon I plan to use (someday) won't even do surgery for six months after someone has had cortisone. I wonder if that contributed to the tendon coming apart. I am so sorry you are going through this.

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1 reply
heyjoe415 | @heyjoe415 | Mar 21 6:00am
In reply to @amywood20 "@mrsflutterby Under the circumstances, I'm surprised they did a cortisone shot. Cortisone can weaken tendons. I..." + (show)
@amywood20

@mrsflutterby Under the circumstances, I'm surprised they did a cortisone shot. Cortisone can weaken tendons. I have a full thickness tear in my right shoulder and have for five years. It's holding and not getting worse. I do not plan to have surgery at this time. I do know that the surgeon I plan to use (someday) won't even do surgery for six months after someone has had cortisone. I wonder if that contributed to the tendon coming apart. I am so sorry you are going through this.

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Sorry about your RC tendon Amy. RC injuries seem to be very hard to fix, and from what Ive read, harder to recover from than a total shoulder replacement.

I've been told the wait time for surgery after a cortisone shot is 3 months. Maybe your situation is different. My understanding is the shot is long gone by 3 months.

One band-aid approach, see if your surgeon will prescribe 5% lidocaine patches. Just a temporary fix.

Reverse total shoulder replacement may also be an option. It has to be "reverse" because of the RC damage, with the titanium ball of the humerus placed on the end of the clavicle and the glenoid (cup) placed on the top of your humerus.

I wish you the best. Im getting a TSR in may. My RC is fortunately intact and so I can do an anatomical replacement.

All the best to you.

Joe

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flyjim | @flyjim | Mar 21 9:22am

Have you looked into Platelet Rich Plasma Therapy. My research indicates numerous positive outcomes with rotator cuff tears. It appears that it forms scar tissue where the tear is. Providing some decent pain relief. Physical therapy is an absolute must to strengthen the shoulder to compensate for the damaged rotator cuff.
I have one RC torn three quarters and the other about halfway through. I had one round last year but life got in the way and I couldn’t get the second or third round so there was minimal relief. The bad part is no insurance coverage at all, and it’s very expensive.
I’m starting again in April and hopefully I can finish all shots initially. I recall that injections might need to be yearly.

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