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  • Labral/Rotator Cuff issues

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    Old 04-30-2014, 06:54 PM   #1
    therapist82
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    Unhappy Labral/Rotator Cuff issues

    I was hoping to get some insight from anyone who has undergone multiple shoulder surgeries for the following issue:

    In 2012 I dislocated my right shoulder. My orthopedic surgeon said it was one of the worst ones he had seen in a while. It was discovered that my labrum was torn and I underwent a SLAP procedure. Following that I had the long head of my bicep tendon cut because it was so badly damaged. Approximately 3 months after that they discovered I had frozen shoulder and I had to go back to the OR so they could break up the scar tissue. Thus far i've had 3 surgeries and went through approximately 9 months of physical therapy (going 3 times per week). I have been experiencing an increased amount of pain recently and had a MRI done the interpretation read Findings: In this patient with a history of labral repair, two
    postsurgical tunnels are noted within the glenoid. The anterior
    labrum demonstrates irregularity in signal intensity and contour
    highly worrisome for a tear.

    Tendinopathy of the supraspinous tendon without a discrete tear.
    There is tendinopathy of the infraspinatus tendon as well as a
    delaminating type tear at the musculotendinous junction. Cystic
    change of the humeral head underlying the rotator cuff is noted.

    The biceps tendon is located within the bicipital groove.

    The acromioclavicular joint is intact. There is a type II
    acromion.

    Small joint effusion.






    Impression:

    In this patient with a history of labral repair, two
    postsurgical tunnels are noted within the glenoid. The anterior
    labrum demonstrates irregularity in signal intensity and contour
    highly worrisome for a tear. Tendinopathy of the supraspinous
    tendon without a discrete tear. There is tendinopathy of the
    infraspinatus tendon as well as a delaminating type tear at the
    musculotendinous junction. Cystic change of the humeral head
    underlying the rotator cuff is noted. Small joint effusion.


    So it appears as if my shoulder is really messed up again and I will most likely need surgery. Especially because my shoulder hurts and is unstable. Has anyone undergone multiple labral repairs or rotator cuff repairs...If so what was you experience like? Any thoughts on my MRI results?

     
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    Old 05-01-2014, 08:00 PM   #2
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    Re: Labral/Rotator Cuff issues

    Hi. Welcome to HealthBoards.

    Your issues are much more complicated than mine in terms of the tears. I can share what I've learned that may correlate a bit. At least enough for you to research some more.

    I have multidirectional instability due to laxity. It is different than your traumatic instability, but the results for both of us is that the shoulder moves around more than it should.

    The Acromion type II means you have a bit of hook that has developed on the acromion. Type III is the worst hook, so it could be worse.

    What I had happen is that with the instability, my shoulder was subluxing with every movement. With the hook, there was less room for the tendons and bursa and they get 'pinched' when the rotator cuff is moved. For me, it caused lots of problems with tendonitis of the supraspinatus and bursitis. This issue is called Shoulder Impingement Syndrome. It can occur in conjunction with rotator cuff tears as well. I had surgery on mine this week to shave down the acromion, remove the bursa, and remove debris from the tendonitis. My hope is that there is more room now to keep the impingement from being so bad and the tendonitis will resolve. If I'd had tears, they would have repaired them at this time as well. It may be worth looking into in addition to your other issues.

    There is surgery to address the instability. I believe it is a Bankart repair. It does run the risk of loss of ROM, but with chronic instability, it is an option.

    Good luck with your doctor's appointment. Keep us posted on how you are doing.
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