Rotator Cuff full tear and retraction of supraspinatus tendon

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.

@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.

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

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.

My husband has two complete cuff tears in his shoulder as well as a partial cuff tear in the same shoulder. He isn’t in pain but can’t lift but a few pounds when the arm is above his shoulder.
Questions, is there any down side as term as muscle atrophy created by waiting a year or two? He is 72 and fairly active!
Thx

Absolutely! It is best to get/keep the surrounding muscles as strong as possible before surgery to minimize recovery time and enhance the chance of success. And the older tears are, the higher the risk that the repair won't work.
He should consult with a doctor who does a lot of shoulder repairs when making this decision. My friend waited, and things deteriorated to the point that she had to have a reverse shoulder replacement rather than a repair. This permanently affects the function and strength of the shoulder.

I wouldn't wait. But, be prepared, it is painful and the recovery is long. But I now have 90% range of motion. I did 64 sessions of PT after surgery but it was worth it. Good luck!

I agree, I'm in PT right now and it is a long haul. First you wait for it to heal before starting PT (in order to make sure it didn't tear out the repairs). I had 3 full tears, one being the bicep. It was repositioned and the other two tendons were reattached. It is a long recovery and you must have patience. If you try to early to use it, you'll damage it. I won't lie, it hasn't been an easy time but my PT is keeping me on track and I get stronger every week.

I'm joining this discussion late so I apologize if I'm repeating something.

FWIW, IMO a badly damaged RC is best treated with a reverse total shoulder replacement. This takes RC health or lack thereof, out of the picture. The deltoid takes over to hold the shoulder in place.

I had an anatomical TSR 5 weeks ago. The rehab is long and patience is required. I'm still glad I did it. My RC was intact. If that had not been the case, I would have had the reverse TSR.

FWIW! All the best to people suffering from chronic shoulder and other joint pain. It sucks.

Joe

Hi Amy,

Sorry about your RC. As far as cortisone, my surgeon required me to wait 3 months after the shot before doing an anatomical TSR. The reason - cortisone weakens the immune system, so greater risk of infection. I had the surgery 5 weeks ago and, so far so good.

And I believe it is correct that cortisone can damage or partially dissolve tendons and ligaments. In the last few years, it's been my experience that surgeons don't see this is a high risk. The bigger problem, IMO, is that cortisone stops working after one or two shots.

As far as whether or not you should get surgery - that depends. Just my opinion but most RC repair surgery has a lengthy recovery and doesn't work as well as just getting a reverse TSR. Do you have arthritis in your shoulder? Are there things you can't do, like certain exercises involving the shoulder like overhead presses or bicep curls?

I ask because with my shoulder, some muscles in my upper back on the surgical side had weakened because of so much time NOT doing those exercises. And that's because I put off surgery too long.

I waited until I had daily pain before getting a TSR. I've also had both knees and one hip replaced, all at the point where I had considerable pain.

My suggestion (and that's all it is) is to talk with your surgeon about a reverse TSR versus repairing the RC versus doing nothing for now. Last note - a reverse TSR is required when the RC is damaged, but I'm guessing you know that.

I hope this is helpful, and all the best to you and everyone battling shoulder and other joint pain.

Joe