I had the balloon arthroplasty on April 26,2023. My physical therapist shared with me a few months ago, that he didn't think my repair worked, because my shoulder had not been progressing as it should be. I went for my 3 month check up, at that time, my arm would only lift my arm half way up(as if to wave). He told me to continue going to therapy(I was going 2x's a week). I went back for my 6 month check up and still no progress. So, now I am having a total replacement on December 29th. I have so many emotions going through me right now. I'm trying to stay positive. I have been following you since well before my 1st surgery. You have answered so many of my questions that I didn't know I should have asked the surgeon prior to surgery. Thank you!!
Cristina, So sorry for your need for another surgery. I know it must be devastating! Just know you have a community here pulling for you. Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
My diagnosis was delayed for four months bc of iron transfusions and an mri being contra indicated as a result. Then another two months for pre-op work-up and scheduling. Add a huge tear and impingement. Then overlay the other shoulder being injured and now 7 weeks post-operative. So 8 months post surgery and rehab my right shoulder is ‘functional’ but not actually day to day ‘fixed’. The left shoulder seems to be leaps and bounds better at 7 weeks even with bicep repair and anchor. I suppose I should be grateful the pain pre-op is diminished and I have better range of motion in the right shoulder but it is my dominant arm and my quality of life isn’t the same. Plus, tingling and pins and needles in my hand. I think my surgeon is very good but I fear his opinion is you have reached standard functionality and that is as good as it gets.
Please consider joining our newsletter. Just email me at dro@mybodyprotector.com and put yes in the subject line and we will get you set up with a few tip sheets as well!
Hey! I have another question. Let's say someone has a planned surgery for a RC repair. On the day of surgery when evaluating the shoulder arthroscopically you notice the labrum is torn and some of the stabilising ligaments are stretched/damaged for example. This may sound silly, but do you repair that damage even though the planned surgery was for a RC repair? Is the surgery typically resolving everything that is noticeably damaged?
Hey Dane good questions. Typically we are prepared to address anything that we encounter during the surgery. The exception would be if we found something that requires a completely different procedure that was beyond the consent. An example is if we see a labral tear we could address this as well or instead of a rotator cuff tear. That being said if severe arthritis was found and you needed a shoulder replacement that would be a very different procedure and would need a different conversation and a different consent.
Hi Dr, Just a quick query. I had acj decompression and a small supraspinatus tendon 4 months ago. I've been doing regular physio therapy but have a strength deficit on external rotation and slight AROM restriction. Problem is at night I engage in 'Rhythmic Movement Disorder' on my bad shoulder. Thats the shoulder I usually prefer to sleep on. It obviously cannot be healthy to my recovery but it's difficult to resist and cause pain/discomfort. Any tips in managing this? I hope you're well and many thanks in advance if you can assist. Matt
Hey Matt, thanks for the comment. I do not treat RMD in my practice and therefore would have to defer to a specialist in this area. There may be meds to take at night time to decrease this but again I am not really familiar with the treatement options. Sorry I couldnt be more helpful.
If biceps tenodesis is done very well and there's no diseased tendon or muscle will the tenodesis last your whole lifetime? Also will a remplissage last whole lifetime? Hoping uou can point me to some proof that these repairs last.
Hey Jim, we anticipate it lasting as long as it is done well. A remplissage is a whole different ball game for a very different problem. Off the top of my head I am unaware of studies that look at the durability of tenodesis.
I had a RTC repair fail during the physical therapy process. The recommendation now is for a revision with cadaver allograft. Have you done these types of revisions? Thanks!
Hey Dan, Yes I have used cadaver grafts for repair. They do much better as an augment ( placed over a tenuous repair) than using it to replace the rotator cuff. Also see my video on SCR. That may be an option as well.
Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
Doc, after a biceps tenodesis is there any data on blood supply to the tendon? How stable in the long-term is a tendon that has been anchored in the bone with a screw? Can it atrophy, eventually, from being pinched on one side? One have one SLAP shoulder w/tenodesis and the other with stitch repair (not great, tight, weird ROM) and I'm thinking about a revision and tenodesis on both shoulders...
Hey Blondie, It depends on how the tenodesis is performed and how diseased the tendon was/is. The tendon is what is reattached not the muscle. (tendon attaches muscle to bone) If done well, once healed the tenodesis is very stable long term. Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
To help your confidence, I had a biceps tenodesis done on my right shoulder on 8th November 2022. I was very worried at the start and during rehab/physical therapy. Just stay positive and do the exercises your physio gives you. Full strength now, ROM back and I'm doing 17 to 20kg bicep curls. Unfortunately my other shoulder has played up so I'm due for a biceps tenodesis, labrum repair and Distal Clavical Excision in March 2024.
Acromio claviclular joint shows oedematous changes in acromio claviclular ligament and marrow edema in distal clavicle on mri..Jasvinder scapular pain last 6 months...Does that changes means TUMOR OR CANCER OF BONE..
Hey I have a question which may be silly, but have you ever or do you regularly do rotator cuff repairs on tendons that have tendinosis in them? How different is doing a rotator cuff repair on a tendon with tendinosis that has ruptured as opposed to a tendon which has just simply ruptured? Appreciate the work you do!
Hey Dane, great question. Most of the RC tears that we work on are older and have an element of tendonitis as well. We do not do anything specific with these tendons as long as they are strong enough to hold the repair. If they are not then we consider patches to reinforce the repair
Wow, That is some great information and need to look into where I'm at and if the Crimson Duvet method will work or if a reverse shoulder replacement is the right option. I hate that this may have to happen being how active I am and that I do lift more on a regular basis that the replacement is able to handle. I wish I was just able to go to a specialist like yourself and have these things done but in the military world that isn't how it works unfortunately. Other than asking about the Goutallier score I'm not sure what else I can ask him right now. Oh he did talk to me about all the muscle turning into fat and he showed it to me and how much has already turned to fat (nearly 50%). He did tell me the same thing you just talked about with respect to re-energizing that muscle (Supraspinatus) and that it more than likely will not rebuild and to not think that a bunch of exercises that normally works out this area would help so I'm just torn on what to do. Any insight you can give will be greatly appreciated! I'm just trying to make the best decision that will help me move forward. Thanks again Dr. Orcutt this just give me more fuel to make a major decision.
Hey Jim, great to hear from you! There are a lot of good docs at the VA. Keep talking to your surgeon and make that educated decision the best you can! Let us know how you are doing.
Interesting stuff indeed Doc, but I’ve seen these scans and it looks like a Doppler radar display from the local weatherman, can they actually come up with this G score from what they’re looking at, mine had a bunch of fluid in white coloring, not sure what they can come up with when they look at this and are they able to determine the length of the tendon from the scans too? Seems really objective
Hey Joe, good question. Actually it is not that hard to see most times. I will post a short about with the pic when I get a second. Thanks for subscribing! Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
@@rotatorcuffexpert I had left soldier surgery in March after the MRI findings revealed a full thickness tear of the supraspinatus, but when they went in, it was a small tear of the supraspinatus caused by a bone spur they removed, and they found subscap tear which they anchored and did the tenodesis; needless to say, I was disappointed in the MRI, and how inaccurate it was, and wondering if an arthrogram should be the way to go in the future with these things, because the certainty seems low
I had the balloon arthroplasty on April 26,2023. My physical therapist shared with me a few months ago, that he didn't think my repair worked, because my shoulder had not been progressing as it should be. I went for my 3 month check up, at that time, my arm would only lift my arm half way up(as if to wave). He told me to continue going to therapy(I was going 2x's a week). I went back for my 6 month check up and still no progress. So, now I am having a total replacement on December 29th. I have so many emotions going through me right now. I'm trying to stay positive. I have been following you since well before my 1st surgery. You have answered so many of my questions that I didn't know I should have asked the surgeon prior to surgery. Thank you!!
Cristina, So sorry for your need for another surgery. I know it must be devastating! Just know you have a community here pulling for you. Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
My diagnosis was delayed for four months bc of iron transfusions and an mri being contra indicated as a result. Then another two months for pre-op work-up and scheduling. Add a huge tear and impingement. Then overlay the other shoulder being injured and now 7 weeks post-operative.
So 8 months post surgery and rehab my right shoulder is ‘functional’ but not actually day to day ‘fixed’.
The left shoulder seems to be leaps and bounds better at 7 weeks even with bicep repair and anchor.
I suppose I should be grateful the pain pre-op is diminished and I have better range of motion in the right shoulder but it is my dominant arm and my quality of life isn’t the same. Plus, tingling and pins and needles in my hand.
I think my surgeon is very good but I fear his opinion is you have reached standard functionality and that is as good as it gets.
Sandra, I think at 7 wks you are still very early in your recovery. Please be patient and try not to compare, even between your own shoulders!
Please consider joining our newsletter. Just email me at dro@mybodyprotector.com and put yes in the subject line and we will get you set up with a few tip sheets as well!
Love the information and like your humor! Thank you
Blake, Thanks for watching! and thanks for subscribing
super helpful thank you
Olitonottero, thanks! good to hear from you.
Hey! I have another question. Let's say someone has a planned surgery for a RC repair. On the day of surgery when evaluating the shoulder arthroscopically you notice the labrum is torn and some of the stabilising ligaments are stretched/damaged for example. This may sound silly, but do you repair that damage even though the planned surgery was for a RC repair? Is the surgery typically resolving everything that is noticeably damaged?
Hey Dane good questions. Typically we are prepared to address anything that we encounter during the surgery. The exception would be if we found something that requires a completely different procedure that was beyond the consent. An example is if we see a labral tear we could address this as well or instead of a rotator cuff tear. That being said if severe arthritis was found and you needed a shoulder replacement that would be a very different procedure and would need a different conversation and a different consent.
@rotatorcuffexpert Thanks for your reply. Very much appreciated! 😊
Hi Dr,
Just a quick query. I had acj decompression and a small supraspinatus tendon 4 months ago.
I've been doing regular physio therapy but have a strength deficit on external rotation and slight AROM restriction.
Problem is at night I engage in 'Rhythmic Movement Disorder' on my bad shoulder. Thats the shoulder I usually prefer to sleep on. It obviously cannot be healthy to my recovery but it's difficult to resist and cause pain/discomfort.
Any tips in managing this?
I hope you're well and many thanks in advance if you can assist.
Matt
Hey Matt, thanks for the comment. I do not treat RMD in my practice and therefore would have to defer to a specialist in this area. There may be meds to take at night time to decrease this but again I am not really familiar with the treatement options. Sorry I couldnt be more helpful.
If biceps tenodesis is done very well and there's no diseased tendon or muscle will the tenodesis last your whole lifetime? Also will a remplissage last whole lifetime? Hoping uou can point me to some proof that these repairs last.
Hey Jim, we anticipate it lasting as long as it is done well. A remplissage is a whole different ball game for a very different problem. Off the top of my head I am unaware of studies that look at the durability of tenodesis.
I had a RTC repair fail during the physical therapy process. The recommendation now is for a revision with cadaver allograft. Have you done these types of revisions? Thanks!
Hey Dan, Yes I have used cadaver grafts for repair. They do much better as an augment ( placed over a tenuous repair) than using it to replace the rotator cuff. Also see my video on SCR. That may be an option as well.
th-cam.com/video/8VR02dvHcwA/w-d-xo.html.
Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
Question I have is this is
My 3rd week after surgery. Still get really tired, is this a normal occurrence
Hey Don, Take your time and be kind to your body in your recovery.
Doc, after a biceps tenodesis is there any data on blood supply to the tendon? How stable in the long-term is a tendon that has been anchored in the bone with a screw? Can it atrophy, eventually, from being pinched on one side? One have one SLAP shoulder w/tenodesis and the other with stitch repair (not great, tight, weird ROM) and I'm thinking about a revision and tenodesis on both shoulders...
Hey Blondie, It depends on how the tenodesis is performed and how diseased the tendon was/is. The tendon is what is reattached not the muscle. (tendon attaches muscle to bone) If done well, once healed the tenodesis is very stable long term. Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
To help your confidence, I had a biceps tenodesis done on my right shoulder on 8th November 2022. I was very worried at the start and during rehab/physical therapy. Just stay positive and do the exercises your physio gives you. Full strength now, ROM back and I'm doing 17 to 20kg bicep curls. Unfortunately my other shoulder has played up so I'm due for a biceps tenodesis, labrum repair and Distal Clavical Excision in March 2024.
Acromio claviclular joint shows oedematous changes in acromio claviclular ligament and marrow edema in distal clavicle on mri..Jasvinder scapular pain last 6 months...Does that changes means TUMOR OR CANCER OF BONE..
See previous response
Hey I have a question which may be silly, but have you ever or do you regularly do rotator cuff repairs on tendons that have tendinosis in them? How different is doing a rotator cuff repair on a tendon with tendinosis that has ruptured as opposed to a tendon which has just simply ruptured? Appreciate the work you do!
Hey Dane, great question. Most of the RC tears that we work on are older and have an element of tendonitis as well. We do not do anything specific with these tendons as long as they are strong enough to hold the repair. If they are not then we consider patches to reinforce the repair
@@rotatorcuffexpert Thanks for your response. Appreciate it. Best regards 🙂
Wow, That is some great information and need to look into where I'm at and if the Crimson Duvet method will work or if a reverse shoulder replacement is the right option. I hate that this may have to happen being how active I am and that I do lift more on a regular basis that the replacement is able to handle. I wish I was just able to go to a specialist like yourself and have these things done but in the military world that isn't how it works unfortunately. Other than asking about the Goutallier score I'm not sure what else I can ask him right now. Oh he did talk to me about all the muscle turning into fat and he showed it to me and how much has already turned to fat (nearly 50%). He did tell me the same thing you just talked about with respect to re-energizing that muscle (Supraspinatus) and that it more than likely will not rebuild and to not think that a bunch of exercises that normally works out this area would help so I'm just torn on what to do. Any insight you can give will be greatly appreciated! I'm just trying to make the best decision that will help me move forward. Thanks again Dr. Orcutt this just give me more fuel to make a major decision.
Hey Jim, great to hear from you! There are a lot of good docs at the VA. Keep talking to your surgeon and make that educated decision the best you can! Let us know how you are doing.
Interesting stuff indeed Doc, but I’ve seen these scans and it looks like a Doppler radar display from the local weatherman, can they actually come up with this G score from what they’re looking at, mine had a bunch of fluid in white coloring, not sure what they can come up with when they look at this and are they able to determine the length of the tendon from the scans too? Seems really objective
Hey Joe, good question. Actually it is not that hard to see most times. I will post a short about with the pic when I get a second. Thanks for subscribing!
Please consider joining our FB group or join our newsletter. Just email us at dro@mybodyprotector.com and put "yes" in the subject line. We will get you signed up and also give you a couple tip sheets!.
@@rotatorcuffexpert I had left soldier surgery in March after the MRI findings revealed a full thickness tear of the supraspinatus, but when they went in, it was a small tear of the supraspinatus caused by a bone spur they removed, and they found subscap tear which they anchored and did the tenodesis; needless to say, I was disappointed in the MRI, and how inaccurate it was, and wondering if an arthrogram should be the way to go in the future with these things, because the certainty seems low