To get shoulder surgery or not.... Dilema I'm facing (1 Viewer)

[top dog]

Last saturday I separated dislocated my shoulder in a mishap. Felt it pop out and back in. Needless to say it hurt like hell when it happened.

Monday I went to the orthopedic walk in clinic at a large practice here in the area. My wife had her shoulder surgery there just over a year ago. Doc does an x-ray and is like "Damn... You broke your socket." You need to see a shoulder specialist. They scheduled me for a CT scan and made an appointment with one of the docs there, but not the one who did my wife's shoulder. The doc I ended up with a much younger doc than my wife's doc. My wife's surgeon is one of the main guys in the practice with a lot more experience.

Wednesday I see my doc and he says "you need surgery to fix the socket or you will always have shoulder instability. But regardless, that shoulder will probably never be the same again." So we schedule a MRI for Thursday and surgery for next week 3/16 so we are on the books pending the MRI verifying everything. After fitting for the post-op brace I asked the doc how many of these surgeries he's done. He assures me he has done a bunch of them. He has been a surgeon for 6 years in this field but if I want a 2nd opinion he totally understands. I tell him that the other doc is my wife's surgeon and I just want to double check with him and see what his thoughts are. "No problem" says my doc. Tells the receptionist to get me an appointment and she gets me in for 9:45 Friday (TODAY)

Today I see my wife's surgeon. He says "My advice is to NOT do the surgery". He recommends to let it heal up on it's own, scar up and see what happens. That I will have some instability in that shoulder but the benefits of the surgery do NOT outweigh the risks. He says there is about an 80% chance that letting it heal up on it's own will result in me being pretty good. Because of my age (49), there is about a 50% chance they do the surgery and I end up with permanent stiffness in the shoulder. I ask him about the prospects of the instability. He says yes, I will be more likely to dislocate my shoulder in the future but at least I won't get stuck not being able to lift my arm over my head again. Also says that if I went and saw 10 orthopedics I'd probably get 5 who say do the surgery and 5 that say don't. I asked him what happens if I'm one of the edge cases and letting it heal and PT don't fix it? Surgery is still an option down the road he said. It's harder on the surgeon doing it because of the scar tissue but the recovery for me whether we do it now or 6 months from now is similar.

I'm probably 75 / 25 leaning towards not doing the surgery but I'm torn. Anybody ever go through a similar thing? Basically when the shoulder separated dislocated the ball sheared off a piece of the bone of the "socket".

 

[Doug B]

Doc does an x-ray and is like "Damn... You broke your socket." ... Basically when the shoulder separated the ball sheared off a piece of the bone of the "socket".

I don't have any experience with this, but I wanted to get something clarified for those that do. It looks like you basically answered it once I got to the end of your OP:


Your shoulder socket ... imagine a bowl or tea-cup shape. Your socket basically has a chunk broken off along the edge, kind of like a large chip on the rim of a tea cup?

 

[top dog]

Doc does an x-ray and is like "Damn... You broke your socket." ... Basically when the shoulder separated the ball sheared off a piece of the bone of the "socket".

I don't have any experience with this, but I wanted to get something clarified for those that do. It looks like you basically answered it once I got to the end of your OP:


Your shoulder socket ... imagine a bowl or tea-cup shape. Your socket basically has a chunk broken off along the edge, kind of like a large chip on the rim of a tea cup?

Yes. That basically is it.

 

[Doug B]

Also ... where is the "chip" in the socket? If your ear is at 12 o'clock, your chest at 3 o'clock, your feet at 6 o'clock, and your back at 9 o'clock, where about would you say your socket "chip" is?

 

[top dog]

Here is the results of my MRI:

FINDINGS:
Posttraumatic changes of recent anterior glenohumeral dislocation
noted. There is a slightly displaced bony Bankart lesion which is
better visualized on the CT measuring approximally 1 cm in size. A
small amount of step-off of the anterior glenoid articular surface
noted with a globular morphology of the anterior labrum consistent
with a component of labral Bankart as well.

Hill-Sachs deformity of the humeral head with marrow edema seen.

There is no evidence of rotator cuff tear. The rotator cuff tendons
have a normal signal and morphology. There is a small amount of
feathery edema of the subscapularis at the muscular belly adjacent to
the scapula likely related to the trauma. The subscapularis tendon
normal.

No large effusion.

Biceps intact.

Mild acromioclavicular osteoarthritis. This causes some mass effect
on the supraspinatus myotendinous junction.

No evidence of other fracture.

No other marrow replacement lesion.

No evidence of a soft tissue mass.


IMPRESSION:
Posttraumatic changes of anterior glenohumeral dislocation with bony
and labral Bankart of the anterior inferior glenoid rim and humeral
head Hill-Sachs deformity.

Mild muscular injury of the subscapularis muscle belly.

Mild acromioclavicular osteoarthritis.

 

[top dog]

Also ... where is the "chip" in the socket? If your ear is at 12 o'clock, your chest at 3 o'clock, your feet at 6 o'clock, and your back at 9 o'clock, where about would you say your socket "chip" is?

On the bottom. 6 o'clock

 

[Steve Tasker]

I'm not a doctor but I've had 3 progressively-more-serious shoulder surgeries so I've seen a lot of these questions.

Your terminology is a little confusing. If you know the actual medical terms for what you have been diagnosed with, it may be easier for me to explain my complications / experience.

Shoulder separation and dislocation are two different things; the terms often get confused. What you have described sounds like a dislocation rather than a separation, but you've used the term separation twice in the post so I am not sure. It sounds like you had a bony Bankhart, which I had as well, but again I'm not sure.

edit - you've posted the medical findings before my response went through.

 

[top dog]

I'm not a doctor but I've had 3 progressively-more-serious shoulder surgeries so I've seen a lot of these questions.

Your terminology is a little confusing. If you know the actual medical terms for what you have been diagnosed with, it may be easier for me to explain my complications / experience.

Shoulder separation and dislocation are two different things; the terms often get confused. What you have described sounds like a dislocation rather than a separation, but you've used the term separation twice in the post so I am not sure. It sounds like you had a bony Bankhart, which I had as well, but again I'm not sure.

I obviously am NOT a doc as well. Dislocation is probably more accurate. And the MRI calls out the "bony Bankhart"

 

[otb2huffing]

Tor Eckman down?

 

[Doug B]

The chip was around 3 o'clock, then, with an anterior dislocation. EDIT: That's why I'm not a doctor -- six o'clock it is.

Others who have been through such an injury, described as in the bolded above, will be able to share their experiences.

 

[Doug B]

And the MRI calls out the "bony Bankhart"

The Bankart lesion is a break in the cartilage on the edge of your shoulder socket. And cartilage doesn't heal as readily as solid bone does.

 

[gianmarco]

While not knowledgeable with the specifics of the surgery to repair this, anytime non-surgical approach is an option, I would recommend that route. As he stated, you can always get the surgery later with little downside to waiting. He clearly outlined some risks with getting the surgery done.

Until there's a clear reason/indication for surgery, I would hold off. I'm glad you got a 2nd opinion. It also doesn't mean the first surgeon you saw is incorrect (basically the 2nd surgeon told you that opinions may vary on best course).

If anything, you can help yourself feel at ease and get one more opinion from a shoulder specialist at another practice. But, personally, I would hold off on surgery for sure.

 

[Steve Tasker]

Here is the results of my MRI:

FINDINGS:
Posttraumatic changes of recent anterior glenohumeral dislocation
noted. There is a slightly displaced bony Bankart lesion which is
better visualized on the CT measuring approximally 1 cm in size. A
small amount of step-off of the anterior glenoid articular surface
noted with a globular morphology of the anterior labrum consistent
with a component of labral Bankart as well.

Hill-Sachs deformity of the humeral head with marrow edema seen.

This is helpful - I have had a very similar diagnosis.

The bony Bankart lesion is basically how you've described it, a small fracture of the shoulder socket, basically. My limited understanding is that it's a "bony" Bankart if the fracture has any bone present, rather than just pure cartilage. Hill-Sachs means you've basically dented the head of the humerus, most likely when the shoulder was popped back in. I also have had both of these.

I opted for surgery. First surgery was an arthroscopic labrum repair. Basically clean up and sew up the cartilage to try to make the shoulder socket intact, get rid of the bony Bankart issue. I was told by my doctor that this holds for the vast majority of patients. It lasted about 1 year before I began dislocating again, and frequently. I lost no range of motion or strength, but I also never gained back the stability.

Second surgery was a "capsular shift", where they basically give up on repairing the labrum and instead try to "tighten up" your shoulder socket using muscle, rotator cuff etc. This was an open surgery, large incision from about my armpit almost to the top of my shoulder. This held for about 8 years before I suffered a dislocation while playing soccer. Afterward, I began experiencing frequent dislocations yet again. Again, before this dislocation I had lost no range of motion or strength, and this time I had felt much more stable in the shoulder compared to the first surgery. The second surgery was a lot more serious, but it had much better results.

Third surgery was a Latarjet procedure. It was described to me as yet another more serious procedure but a last-step before pursuing a shoulder replacement. Basically they cut a small bone (coracoid process is the bone) and screw it into the front of your shoulder socket, so you now have a bone for shoulder socket instead of cartilage. I have two screws in my shoulder and there's a long thread about it somewhere in this forum. As of now, knock on wood, it feels better than ever. I have lost the slightest bit of range of motion but my daily life is back to normal and the shoulder feels very stable.

I will note that I was younger than you during the course of all of these surgeries (approx 19, 21, and 29-30 when I had them) so recovery was much different. I also took the recovery very seriously, never missed physical therapy, did my exercises at home, etc. None of us here can give you any better advice than your doctors, but this has been my experience. I am certainly not a doctor and this is not medical advice. Happy to answer any questions.

 

[top dog]

Here is the results of my MRI:

FINDINGS:
Posttraumatic changes of recent anterior glenohumeral dislocation
noted. There is a slightly displaced bony Bankart lesion which is
better visualized on the CT measuring approximally 1 cm in size. A
small amount of step-off of the anterior glenoid articular surface
noted with a globular morphology of the anterior labrum consistent
with a component of labral Bankart as well.

Hill-Sachs deformity of the humeral head with marrow edema seen.

This is helpful - I have had a very similar diagnosis.

The bony Bankart lesion is basically how you've described it, a small fracture of the shoulder socket, basically. My limited understanding is that it's a "bony" Bankart if the fracture has any bone present, rather than just pure cartilage. Hill-Sachs means you've basically dented the head of the humerus, most likely when the shoulder was popped back in. I also have had both of these.

I opted for surgery. First surgery was an arthroscopic labrum repair. Basically clean up and sew up the cartilage to try to make the shoulder socket intact, get rid of the bony Bankart issue. I was told by my doctor that this holds for the vast majority of patients. It lasted about 1 year before I began dislocating again, and frequently. I lost no range of motion or strength, but I also never gained back the stability.

Second surgery was a "capsular shift", where they basically give up on repairing the labrum and instead try to "tighten up" your shoulder socket using muscle, rotator cuff etc. This was an open surgery, large incision from about my armpit almost to the top of my shoulder. This held for about 8 years before I suffered a dislocation while playing soccer. Afterward, I began experiencing frequent dislocations yet again. Again, before this dislocation I had lost no range of motion or strength, and this time I had felt much more stable in the shoulder compared to the first surgery. The second surgery was a lot more serious, but it had much better results.

Third surgery was a Latarjet procedure. It was described to me as yet another more serious procedure but a last-step before pursuing a shoulder replacement. Basically they cut a small bone (coracoid process is the bone) and screw it into the front of your shoulder socket, so you now have a bone for shoulder socket instead of cartilage. I have two screws in my shoulder and there's a long thread about it somewhere in this forum. As of now, knock on wood, it feels better than ever. I have lost the slightest bit of range of motion but my daily life is back to normal and the shoulder feels very stable.

I will note that I was younger than you during the course of all of these surgeries (approx 19, 21, and 29-30 when I had them) so recovery was much different. I also took the recovery very seriously, never missed physical therapy, did my exercises at home, etc. None of us here can give you any better advice than your doctors, but this has been my experience. I am certainly not a doctor and this is not medical advice. Happy to answer any questions.

Thanks for your insight. All of that just made my shoulder hurt more! That sounds horrible.

I do like the 1st doc but his is pretty new. Has been in practice since 2022. The 2nd opinion doc has been in practice since 2003 and has been a team physician for the Los Angeles Lakers, Dodgers, Sparks, Galaxy and Kings, as well as the Anaheim Angels and Mighty Ducks. He is also the division chief in orthopedics here. It's hard to dismiss his advice when he says "If it were MY shoulder, I would not do the surgery at your age. 30 and under? We do the surgery every single instance. 49? Very high chance of frozen shoulder"

 

[top dog]

While not knowledgeable with the specifics of the surgery to repair this, anytime non-surgical approach is an option, I would recommend that route. As he stated, you can always get the surgery later with little downside to waiting. He clearly outlined some risks with getting the surgery done.

Until there's a clear reason/indication for surgery, I would hold off. I'm glad you got a 2nd opinion. It also doesn't mean the first surgeon you saw is incorrect (basically the 2nd surgeon told you that opinions may vary on best course).

If anything, you can help yourself feel at ease and get one more opinion from a shoulder specialist at another practice. But, personally, I would hold off on surgery for sure.

That is kind of where I'm at. I'm not going to make the decision 100% until I've had a chance to think it through the weekend and of course get my advice from my favorite message board.

And the 2nd doc said as much about the option of surgery. He didn't say it was the wrong choice, just not advised because of my age and risks. May end up having to do it in 6 months, but maybe not.

 

[fruity pebbles]

I’d hold off on surgery and see how the recovery goes. You can always have surgery down the road if it keeps popping out. Anecdotal I know but a friend of mine, after years of mountain bike riding, had both shoulders popping out on a somewhat regular basis. He had one shoulder done then the other. The recovery was so long and tedious, he said he’d have just lived with it. Personally, I’d never opt for surgery unless there was no other option.

 

[Gally]

What do you plan to do in the future that may or may not need your shoulder? By that I mean, do you play mens baseball or coach baseball where you need to throw with that shoulder? Do you rock climb, play basketball or tennis that will make you need overhead movement and strength from your shoulder?

If you don't do any of those things and are just a typical old guy that doesn't need shoulder strength/range of motion extremes then you probably can get away with no surgery and then just deal with the limitations as you grow older. If you need your shoulder for things you plan to do as a quality of life then getting the surgery while younger and stabilizing it is probably the right answer.

I did a similar thing to my shoulder many, many years ago. They couldn't find any issues beyond the separation and then going back in on it's own. I was prescribed PT and did that. But I coached baseball at the time. Once healed I went back to throwing which included batting practice for the team so I would throw 150 times every couple days during practice. My shoulder was never "right". I always had some level of pain. That went on for about 10 years when the pain became too much to bear. So I had more imaging done and it turned out I had an impingement on the rotator cuff so they did surgery. Once they were into the surgery it turned out I also had a torn labrum so they repaired that as well. It was likely my pain was mostly from the torn labrum which based on the way it was torn it wasn't able to be seen via MRI.

All in all shoulder issues suck.

 

[Hawks64]

Here is the results of my MRI:

FINDINGS:
Posttraumatic changes of recent anterior glenohumeral dislocation
noted. There is a slightly displaced bony Bankart lesion which is
better visualized on the CT measuring approximally 1 cm in size. A
small amount of step-off of the anterior glenoid articular surface
noted with a globular morphology of the anterior labrum consistent
with a component of labral Bankart as well.

Hill-Sachs deformity of the humeral head with marrow edema seen.

This is helpful - I have had a very similar diagnosis.

The bony Bankart lesion is basically how you've described it, a small fracture of the shoulder socket, basically. My limited understanding is that it's a "bony" Bankart if the fracture has any bone present, rather than just pure cartilage. Hill-Sachs means you've basically dented the head of the humerus, most likely when the shoulder was popped back in. I also have had both of these.

I opted for surgery. First surgery was an arthroscopic labrum repair. Basically clean up and sew up the cartilage to try to make the shoulder socket intact, get rid of the bony Bankart issue. I was told by my doctor that this holds for the vast majority of patients. It lasted about 1 year before I began dislocating again, and frequently. I lost no range of motion or strength, but I also never gained back the stability.

Second surgery was a "capsular shift", where they basically give up on repairing the labrum and instead try to "tighten up" your shoulder socket using muscle, rotator cuff etc. This was an open surgery, large incision from about my armpit almost to the top of my shoulder. This held for about 8 years before I suffered a dislocation while playing soccer. Afterward, I began experiencing frequent dislocations yet again. Again, before this dislocation I had lost no range of motion or strength, and this time I had felt much more stable in the shoulder compared to the first surgery. The second surgery was a lot more serious, but it had much better results.

Third surgery was a Latarjet procedure. It was described to me as yet another more serious procedure but a last-step before pursuing a shoulder replacement. Basically they cut a small bone (coracoid process is the bone) and screw it into the front of your shoulder socket, so you now have a bone for shoulder socket instead of cartilage. I have two screws in my shoulder and there's a long thread about it somewhere in this forum. As of now, knock on wood, it feels better than ever. I have lost the slightest bit of range of motion but my daily life is back to normal and the shoulder feels very stable.

I will note that I was younger than you during the course of all of these surgeries (approx 19, 21, and 29-30 when I had them) so recovery was much different. I also took the recovery very seriously, never missed physical therapy, did my exercises at home, etc. None of us here can give you any better advice than your doctors, but this has been my experience. I am certainly not a doctor and this is not medical advice. Happy to answer any questions.

Thanks for your insight. All of that just made my shoulder hurt more! That sounds horrible.

I do like the 1st doc but his is pretty new. Has been in practice since 2022. The 2nd opinion doc has been in practice since 2003 and has been a team physician for the Los Angeles Lakers, Dodgers, Sparks, Galaxy and Kings, as well as the Anaheim Angels and Mighty Ducks. He is also the division chief in orthopedics here. It's hard to dismiss his advice when he says "If it were MY shoulder, I would not do the surgery at your age. 30 and under? We do the surgery every single instance. 49? Very high chance of frozen shoulder"

Those two things make it very easy IMO. No surgery. He has significantly more experience than the other doc and he has very valid reasons for his decision. I would heal up and see how it progresses over time.

 

[DocHolliday]

I’d hold off on surgery and see how the recovery goes. You can always have surgery down the road if it keeps popping out. Anecdotal I know but a friend of mine, after years of mountain bike riding, had both shoulders popping out on a somewhat regular basis. He had one shoulder done then the other. The recovery was so long and tedious, he said he’d have just lived with it. Personally, I’d never opt for surgery unless there was no other option.

This. Let the shoulder heal and see how it feels and functions.

 

[top dog]

What do you plan to do in the future that may or may not need your shoulder? By that I mean, do you play mens baseball or coach baseball where you need to throw with that shoulder? Do you rock climb, play basketball or tennis that will make you need overhead movement and strength from your shoulder?

If you don't do any of those things and are just a typical old guy that doesn't need shoulder strength/range of motion extremes then you probably can get away with no surgery and then just deal with the limitations as you grow older. If you need your shoulder for things you plan to do as a quality of life then getting the surgery while younger and stabilizing it is probably the right answer.

I did a similar thing to my shoulder many, many years ago. They couldn't find any issues beyond the separation and then going back in on it's own. I was prescribed PT and did that. But I coached baseball at the time. Once healed I went back to throwing which included batting practice for the team so I would throw 150 times every couple days during practice. My shoulder was never "right". I always had some level of pain. That went on for about 10 years when the pain became too much to bear. So I had more imaging done and it turned out I had an impingement on the rotator cuff so they did surgery. Once they were into the surgery it turned out I also had a torn labrum so they repaired that as well. It was likely my pain was mostly from the torn labrum which based on the way it was torn it wasn't able to be seen via MRI.

All in all shoulder issues suck.

Great points as well. I'm right handed so I can still throw a baseball to my grandkids if needed. I'm a typical old guy with a bad knee and now a bad shoulder. My ideal vacation is drinking too much gambling in vegas with the wife. Maybe laying on a beach.

 

[FlagDynasty]

I recently came across a really good description of a similar procedure for those still wondering whether surgery is necessary or not. In short, arthroscopic shoulder surgery can help a lot, but the risks and recovery time definitely need to be carefully considered. If you want to see clear details about what it involves, take a look here at this page about arthroscopic shoulder surgery. It might help you make a more informed decision, especially if you’re as uncertain as you seem to be.

 

[Beef Ravioli Part 2]

If you are given an option to hold off, I would hold off. Especially since surgery down the road is an option. Seen to many friends and family regret getting surgery.

 

[Gally]

If you are given an option to hold off, I would hold off. Especially since surgery down the road is an option. Seen to many friends and family regret getting surgery.

Regretted having the surgery, why? If you are in pain and not able to do the things you want/need to do and surgery can help why put it off? I had shoulder surgery when it was aching me all the time and made it tough to sleep. While it didn't bring it to 100% it is much better than it was and the doctor repaired a torn labrum that didn't show up on the 4 or 5 MRI's I had over the years to figure out what was wrong.

 

[FiredMartz]

I had rotator cuff surgery on both shoulders....long recovery but worth it....

 

[Beef Ravioli Part 2]

If you are given an option to hold off, I would hold off. Especially since surgery down the road is an option. Seen to many friends and family regret getting surgery.

Regretted having the surgery, why? If you are in pain and not able to do the things you want/need to do and surgery can help why put it off? I had shoulder surgery when it was aching me all the time and made it tough to sleep. While it didn't bring it to 100% it is much better than it was and the doctor repaired a torn labrum that didn't show up on the 4 or 5 MRI's I had over the years to figure out what was wrong.

Regretted the surgery because it did not help and in some cases had gotten worse. If given the option of physical therapy possibly helping, then try that.

I also just realized this thread was bumped from two years ago. The OP probably could answer this question for us.

 

[Gally]

Regretted the surgery because it did not help

What was the issue you had in the shoulder? Torn Labrum? Torn Rotator Cuff? Just wondering what was found or thought to be the issue. Shoulders are very complicated joints with a lot going on in there.

I had a torn labrum and tried PT for years. Nothing helped but they also couldn't see the tear on multiple MRI's. I finally had surgery when they found a bone spur impinging on my rotator cuff and only found the labrum tear when they went in arthroscopically. While my shoulder isn't good as new it is better.

 

[Judge Smails]

I had a full depth tear to rotator cuff + torn labrum and torn bicep. It had gotten to the point where there was no position I could sleep. Golf was reduced to a half swing which I’m still trying to lengthen. Finally had surgery. Well worth it though PT was a *****. Took 9 months for me to golf again. If you aren’t going to commit to PT then don’t do these surgeries. I’ve had friends blow off PT for knee replacements etc and are gimping around.

 

[belljr]

I've been doing PT for almost 6 weeks. While I feel better, certain angles and movements still hurt. Follow up with Ortho Friday, then probably MRI

 

[Beef Ravioli Part 2]

Regretted the surgery because it did not help

What was the issue you had in the shoulder? Torn Labrum? Torn Rotator Cuff? Just wondering what was found or thought to be the issue. Shoulders are very complicated joints with a lot going on in there.

I had a torn labrum and tried PT for years. Nothing helped but they also couldn't see the tear on multiple MRI's. I finally had surgery when they found a bone spur impinging on my rotator cuff and only found the labrum tear when they went in arthroscopically. While my shoulder isn't good as new it is better.

I never had a surgery on my shoulder. I responded to the topic of surgery or therapy. I said I would try the therapy instead of the surgery because I’ve had too many friends regret having surgery instead of trying therapy. You asked why did they regret it and I said because the surgery didn’t work and their pain was worse. I never had surgery. I was saying my friends had poor experiences therefore, if this guy could try therapy rather than surgery first go for that.

 

[FiredMartz]

I had a full depth tear to rotator cuff + torn labrum and torn bicep. It had gotten to the point where there was no position I could sleep. Golf was reduced to a half swing which I’m still trying to lengthen. Finally had surgery. Well worth it though PT was a *****. Took 9 months for me to golf again. If you aren’t going to commit to PT then don’t do these surgeries. I’ve had friends blow off PT for knee replacements etc and are gimping around.

After both rotator cuff surgeries I did all the PT....and still got what they call 'Frozen Shoulder" i.e scar tissue....which requires another surgery....which really isn't a surgery....I believe they put you under and lay you on your stomach and wrench your shoulder way back to tear the tissue....then PT again

 

[Gally]

I had a full depth tear to rotator cuff + torn labrum and torn bicep. It had gotten to the point where there was no position I could sleep. Golf was reduced to a half swing which I’m still trying to lengthen. Finally had surgery. Well worth it though PT was a *****. Took 9 months for me to golf again. If you aren’t going to commit to PT then don’t do these surgeries. I’ve had friends blow off PT for knee replacements etc and are gimping around.

After both rotator cuff surgeries I did all the PT....and still got what they call 'Frozen Shoulder" i.e scar tissue....which requires another surgery....which really isn't a surgery....I believe they put you under and lay you on your stomach and wrench your shoulder way back to tear the tissue....then PT again

Sounds fun

 

[belljr]

Appointment Monday but this doesn't sound good?

FINDINGS:


Osseous Structures: No bone marrow edema.

Rotator Cuff: Supraspinatus and infraspinous tendons appear intact. There is
thickening of the subscapularis tendon with tendinosis.

Subacromial-Subdeltoid Bursa: No fluid.

Acromioclavicular Joint: Mild osteoarthrosis.

Glenohumeral Joint: No joint effusion. Anterior joint capsule appears
thickened.

Labrum: No evidence of superior labral tear. The anterior labrum appears torn
on the axial images.

Biceps Tendon: Normally positioned, grossly intact.

 

[gianmarco]

Appointment Monday but this doesn't sound good?

FINDINGS:


Osseous Structures: No bone marrow edema.

Rotator Cuff: Supraspinatus and infraspinous tendons appear intact. There is
thickening of the subscapularis tendon with tendinosis.

Subacromial-Subdeltoid Bursa: No fluid.

Acromioclavicular Joint: Mild osteoarthrosis.

Glenohumeral Joint: No joint effusion. Anterior joint capsule appears
thickened.

Labrum: No evidence of superior labral tear. The anterior labrum appears torn
on the axial images.

Biceps Tendon: Normally positioned, grossly intact.

Overall, nothing overly concerning. The anterior labral tear is the main issue and usually attempt conservative treatment (PT) first.

 

[Terminalxylem]

Appointment Monday but this doesn't sound good?

FINDINGS:


Osseous Structures: No bone marrow edema.

Rotator Cuff: Supraspinatus and infraspinous tendons appear intact. There is
thickening of the subscapularis tendon with tendinosis.

Subacromial-Subdeltoid Bursa: No fluid.

Acromioclavicular Joint: Mild osteoarthrosis.

Glenohumeral Joint: No joint effusion. Anterior joint capsule appears
thickened.

Labrum: No evidence of superior labral tear. The anterior labrum appears torn
on the axial images.

Biceps Tendon: Normally positioned, grossly intact.

Overall, nothing overly concerning. The anterior labral tear is the main issue and usually attempt conservative treatment (PT) first.

Agreed. Pretty meh findings, in a middle aged shoulder.

 

[belljr]

Appointment Monday but this doesn't sound good?

FINDINGS:


Osseous Structures: No bone marrow edema.

Rotator Cuff: Supraspinatus and infraspinous tendons appear intact. There is
thickening of the subscapularis tendon with tendinosis.

Subacromial-Subdeltoid Bursa: No fluid.

Acromioclavicular Joint: Mild osteoarthrosis.

Glenohumeral Joint: No joint effusion. Anterior joint capsule appears
thickened.

Labrum: No evidence of superior labral tear. The anterior labrum appears torn
on the axial images.

Biceps Tendon: Normally positioned, grossly intact.

Overall, nothing overly concerning. The anterior labral tear is the main issue and usually attempt conservative treatment (PT) first.

I already did cortisone and 6 weeks PT.... Still hurts lifting my arm and clicks and pops :( Still can't throw or lift. And hurts to golf ....guess I'll find out Monday the next step.

Years of abuse and getting old sucks

 

[belljr]

So bumping this thread

Follow up today and my doctor recommended I get shoulder surgery. It's actually for my bicep tendon.

I was given 3 options

1) deal with it as is but do daily exercises to prevent onset of frozen shoulder. I can deal with it 75% of the time but it's starting to hurt daily activities... So this option will lose out eventually

2) bicep tenotomy --- cut the tendon and allows it to retract to the upper arm

Positive only about 6 weeks recovery and pretty easy

Negative 40% chance of "Popeye" bicep. Basically the bicep drops a little and you get a Popeye looking bicep

3) bicep tenodesis --- this puts a new anchor point into the shoulder

Positive very very low chance of Popeye bicep

Negative --2.5 to 3 month recovery. Tenodesis has a slightly better long term relief but I'm in my mid 50s and not throwing up racks anymore

Anyone done either of these?

Thoughts? Tia

 

[Joe Bryant]

So bumping this thread

Follow up today and my doctor recommended I get shoulder surgery. It's actually for my bicep tendon.

I was given 3 options

1) deal with it as is but do daily exercises to prevent onset of frozen shoulder. I can deal with it 75% of the time but it's starting to hurt daily activities... So this option will lose out eventually

2) bicep tenotomy --- cut the tendon and allows it to retract to the upper arm

Positive only about 6 weeks recovery and pretty easy

Negative 40% chance of "Popeye" bicep. Basically the bicep drops a little and you get a Popeye looking bicep

3) bicep tenodesis --- this puts a new anchor point into the shoulder

Positive very very low chance of Popeye bicep

Negative --2.5 to 3 month recovery. Tenodesis has a slightly better long term relief but I'm in my mid 50s and not throwing up racks anymore

Anyone done either of these?

Thoughts? Tia

Good luck there. Sorry I'm not much help there.

My very limited personal experience is people I know who've had various types of shoulder surgery and it seems like more of them regret it than I would have thought. Super wide range and small sample size though so basically meaningless.

For the "Popeye Bicep", my brother in law has this he thinks its fun. Always tells people he just works out with only that arm.

 

[kupcho1]

I'm probably 75 / 25 leaning towards not doing the surgery but I'm torn.

Given the more experienced doctor that your wife had a good experience with recommended not doing it, I'd be 100% wait and see.
I vote: Don't do it.

 

[Gally]

Negative 40% chance of "Popeye" bicep.

How is this is a negative? I mean you get Popeye arms without having to eat spinich. Awesome!



ETA: Serious answer.....what is the problem with popeye arm? If it doesn't hurt or prevent you from doing anything you want to do then it doesn't seem like it would be much of an issue. However, if it stops you from golfing, bowling, playing catch with your grandkids or any other activity you like to do then maybe the full surgery is the way to go.

 

[top dog]

To update my situation, I opted for no surgery. Don't regret it. occasionally my shoulder will bark at me if I do something weird to it. Wearing a backpack for a convention last year made it sore, but overall it's fine. My wife had her AC Joint surgically fixed, rotator cuff and bicep tendon. Her shoulder will never be 100% but she is no longer in pain and does not regret the surgery even though the recovery seemed like it took forever (about 7 months).

 

[DA RAIDERS]

Just an opinion from a knob on the interment. I’d go no surgery. Do your PT religiously. See what happens. I tore my rotator cuff in two places. I couldn’t lift my arm and had zero strength at certain rotations. PT was at least 6 months. It’s not perfect, bugs me some times. But it’s more or less just fine. I do the full PT workout once a week, on my own,. 2 years later.

Not the same injury, but PT worked for me.

 

[belljr]

Just an opinion from a knob on the interment. I’d go no surgery. Do your PT religiously. See what happens. I tore my rotator cuff in two places. I couldn’t lift my arm and had zero strength at certain rotations. PT was at least 6 months. It’s not perfect, bugs me some times. But it’s more or less just fine. I do the full PT workout once a week, on my own,. 2 years later.

Not the same injury, but PT worked for me.

Being doing pt and exercises since April.

It hurts golfing, it hurts trying to make any throw motion, it hurts if I do a upright row motion.....

I'm zero percent better since January

I'm not rushing to get surgery but it relieves the daily pain. I'm seriously thinking about it

 

[Gally]

I'm not rushing to get surgery but it relieves the daily pain. I'm seriously thinking about it

I had a torn labrum in my shoulder for years and years. Only hurt throwing and anything that had that motion for a long time. Eventually it got to where it just ached and was causing me to not sleep because I couldn't get in a position where it didn't hurt.

Had surgery and the pain is gone. My shoulder is definitely not the same (I have no juice on my fastball anymore and need a relay man if I play long toss with Gally jr). but the everyday pain is gone.

I would get the surgery but that comes from a labrum tear and rotator cuff impingement surgery. I have no experience with a bicep issue (and I still think Popeye arm would be cool).

 

[ProstheticRGK]

So bumping this thread

Follow up today and my doctor recommended I get shoulder surgery. It's actually for my bicep tendon.

I was given 3 options

1) deal with it as is but do daily exercises to prevent onset of frozen shoulder. I can deal with it 75% of the time but it's starting to hurt daily activities... So this option will lose out eventually

2) bicep tenotomy --- cut the tendon and allows it to retract to the upper arm

Positive only about 6 weeks recovery and pretty easy

Negative 40% chance of "Popeye" bicep. Basically the bicep drops a little and you get a Popeye looking bicep

3) bicep tenodesis --- this puts a new anchor point into the shoulder

Positive very very low chance of Popeye bicep

Negative --2.5 to 3 month recovery. Tenodesis has a slightly better long term relief but I'm in my mid 50s and not throwing up racks anymore

Anyone done either of these?

Thoughts? Tia

Did they explain to you how the biceps tenotomy/tenodesis would help alleviate your pain? Just looking at your MRI, it seems like you burst your bursa and have no joint lube in there, so you’re bone-on-bone. Structurally, everything is normal-ish for dudes our age?

I’m not qualified to diagnose or give advice, but one thing I determined for myself, working 12 years in the OR and doing a lot of Ortho cases: Surgery on shoulder and back is always a last resort, after exhausting every other treatment.

 

[belljr]

So bumping this thread

Follow up today and my doctor recommended I get shoulder surgery. It's actually for my bicep tendon.

I was given 3 options

1) deal with it as is but do daily exercises to prevent onset of frozen shoulder. I can deal with it 75% of the time but it's starting to hurt daily activities... So this option will lose out eventually

2) bicep tenotomy --- cut the tendon and allows it to retract to the upper arm

Positive only about 6 weeks recovery and pretty easy

Negative 40% chance of "Popeye" bicep. Basically the bicep drops a little and you get a Popeye looking bicep

3) bicep tenodesis --- this puts a new anchor point into the shoulder

Positive very very low chance of Popeye bicep

Negative --2.5 to 3 month recovery. Tenodesis has a slightly better long term relief but I'm in my mid 50s and not throwing up racks anymore

Anyone done either of these?

Thoughts? Tia

Did they explain to you how the biceps tenotomy/tenodesis would help alleviate your pain? Just looking at your MRI, it seems like you burst your bursa and have no joint lube in there, so you’re bone-on-bone. Structurally, everything is normal-ish for dudes our age?

I’m not qualified to diagnose or give advice, but one thing I determined for myself, working 12 years in the OR and doing a lot of Ortho cases: Surgery on shoulder and back is always a last resort, after exhausting every other treatment.

Yes. My doctor is one of the tops in the area. I've had pt, cortisone, stretches etc it's just getting to be a bother moving and sleeping

As Gally said. He needs a cut off. I can't physically throw more than 10ft or I will collapse from pain

Again I appreciate all input

 

[ProstheticRGK]

So bumping this thread

Follow up today and my doctor recommended I get shoulder surgery. It's actually for my bicep tendon.

I was given 3 options

1) deal with it as is but do daily exercises to prevent onset of frozen shoulder. I can deal with it 75% of the time but it's starting to hurt daily activities... So this option will lose out eventually

2) bicep tenotomy --- cut the tendon and allows it to retract to the upper arm

Positive only about 6 weeks recovery and pretty easy

Negative 40% chance of "Popeye" bicep. Basically the bicep drops a little and you get a Popeye looking bicep

3) bicep tenodesis --- this puts a new anchor point into the shoulder

Positive very very low chance of Popeye bicep

Negative --2.5 to 3 month recovery. Tenodesis has a slightly better long term relief but I'm in my mid 50s and not throwing up racks anymore

Anyone done either of these?

Thoughts? Tia

Did they explain to you how the biceps tenotomy/tenodesis would help alleviate your pain? Just looking at your MRI, it seems like you burst your bursa and have no joint lube in there, so you’re bone-on-bone. Structurally, everything is normal-ish for dudes our age?

I’m not qualified to diagnose or give advice, but one thing I determined for myself, working 12 years in the OR and doing a lot of Ortho cases: Surgery on shoulder and back is always a last resort, after exhausting every other treatment.

Yes. My doctor is one of the tops in the area. I've had pt, cortisone, stretches etc it's just getting to be a bother moving and sleeping

As Gally said. He needs a cut off. I can't physically throw more than 10ft or I will collapse from pain

Again I appreciate all input

I could deal with not being able to throw. I gave up on my dream of being an NFL QB when I turned 40.

But no golf?!?! Hell naw!

 

[DA RAIDERS]

Just an opinion from a knob on the interment. I’d go no surgery. Do your PT religiously. See what happens. I tore my rotator cuff in two places. I couldn’t lift my arm and had zero strength at certain rotations. PT was at least 6 months. It’s not perfect, bugs me some times. But it’s more or less just fine. I do the full PT workout once a week, on my own,. 2 years later.

Not the same injury, but PT worked for me.

Being doing pt and exercises since April.

It hurts golfing, it hurts trying to make any throw motion, it hurts if I do a upright row motion.....

I'm zero percent better since January

I'm not rushing to get surgery but it relieves the daily pain. I'm seriously thinking about it

My recovery took a loooong time. There were times where I thought it wasn’t going to work and that surgery was my only option. So I get it. And mine was totally different than yours.

 

[DA RAIDERS]

Yea. I don’t even try to throw anything over hand

 

[belljr]

If it didn't hurt golfing I wouldn't even be in this thread LOL

 

[Ministry of Pain]

So bumping this thread

Follow up today and my doctor recommended I get shoulder surgery. It's actually for my bicep tendon.

I was given 3 options

1) deal with it as is but do daily exercises to prevent onset of frozen shoulder. I can deal with it 75% of the time but it's starting to hurt daily activities... So this option will lose out eventually

2) bicep tenotomy --- cut the tendon and allows it to retract to the upper arm

Positive only about 6 weeks recovery and pretty easy

Negative 40% chance of "Popeye" bicep. Basically the bicep drops a little and you get a Popeye looking bicep

3) bicep tenodesis --- this puts a new anchor point into the shoulder

Positive very very low chance of Popeye bicep

Negative --2.5 to 3 month recovery. Tenodesis has a slightly better long term relief but I'm in my mid 50s and not throwing up racks anymore

Anyone done either of these?

Thoughts? Tia

It's your body but even in your 50s I would think long term
You might not see yourself playing pickleball or other activities but I wouldn't want anything to be taken away from me.
2.5 months put you right at Christmas/New Years, you'll feel a lot better and time will go by fast
2026 you are out doing whatever you like to do

I would invest in yourself for the long term and not cut corners on rehab time