full thickness tear of the supraspinatus tendon surgery

What does a "full thickness tear of the supraspinatus tendon" mean? Also if I don eventually need surgery will it hurt to wait until I absolutely need it. There is certainly good clinical research evidence indicating that arthroscopic surgery can help the types of injuries you described. In terms of general information that may be useful to you, I am not sure I have seen any sound clinical research evidence indicating that prolotherapy is likely to provide long lasting benefits for people with MRI diagnosed supraspinatus tendon tears. An Overview of a Supraspinatus Tendon Tear. )amount of fluid in acromioclavicular joint and last but not least 5.) Tendinosis means that the tendon has some damage at the cellular level (generally where there has been repeated amounts of small damage (sometimes called microtrauma) that your body has tried to repair), but there is not swelling (inflammation) currently present. Most tears occur in the supraspinatus tendon, but other parts of the rotator cuff may also be involved. Even if surgery is required, the physical therapy program can help strengthen the rotator cuff muscles before the surgery. My arm was nearly frozen for a period of about 10 minutes, but I slowly started regaining some ROM. Decided to see ortho who ordered an MRi last week. Your message has been successfully sent to your colleague. The review will consider studies that include elderly patients aged 60 and over who have full thickness rotator cuff tears confirmed with magnetic resonance imaging (MRI), ultrasound or arthrography. sir i am a shuttle badminton player.. i got injury on my shoulder .. doc told to tke MRI scan.. after taking MRI scan these are the final impressions.. 1.partial tear in the supraspinatus tendon at the level of insertion in the greater tubersity for a length of about 15mm with intact insertion, 2 partial tear in the anterior superior labrum. (Left) The front view of a normal rotator cuff. It is one of the four rotator cuff muscles. However, your doctor may also suggest surgery if you are very active and/or use your arms for overhead work or sports. It should be noted that some rotator cuff tears are not painful. there is no focal atrophy or fatty infiltration.that is my M.R. Repair of high-grade partial thickness supraspinatus tears after A soft tissue hematoma occurs when a ruptured blood vessel leaks blood into the surrounding fatty tissue. So quite often the best treatment approach is not always immediately clear. A full thickness tear of the supraspinatus. Indirect signs on MRI are - subdeltoid bursal effusion, particularly if anterior, medial dislocation of biceps, fluid along biceps tendon . Impression: moderate supraspinatus tendinosis with a small full thickness footplate tear. Tearing can be caused by atraumatic tears due to overuse and longstanding degeneration.4 Tear enlargement can occur due to increasing age.2 Patients who experience enlarging rotator cuff tears are five times more likely to develop symptoms than those with tears that remain the same.2 Older individuals have progressively become more active, increasing the chances of sustaining large and massive rotator cuff tears. We will also discuss surgical interventions for tendon injuries. Effects of Rotator Cuff Pathology and Physical Therapy on In Vivo Shoulder Motion and Clinical Outcomes in Patients With a Symptomatic Full-Thickness Rotator Cuff Tear. So probably worthwhile having a chat with your doctor and seeing what they recommend as a first step. However, I can just mention some general information that may be of interest. Physiotherapy, including stretching and strengthening exercises, electrotherapy, ultrasound, moist heat and laser therapy. Drugs, supplements, and natural remedies may have dangerous side effects. 13. That being said, I am scheduled for surgery on 6 Nov. Thanks for sharing this detailed account with everyone. It is good that you have discussed the recovery with your surgeon already. Thanks for stopping by and sharing your story. If you are in doubt, don't be afraid to get a second opinion. There may also be insurance implications etc. Don't be afraid to ask your surgeon about all your treatment options. Partial thickness tears of the supraspinatus muscle are an incomplete disruption of muscle fibers; note that these can progress to a complete or full thickness tear of the supraspinatus muscle, and larger tears pose a higher risk of progression to full tears, even if they are asymptomatic. Remember that you are not aiming for speed; slow, steady, and controlled movement is best. Remaining tendons of the rotator cuff are normal in signal and morphology. Partial thickness tearing is where only a portion of the tendon is torn and part of the tendon is still attached to the humeral head. Full thickness tear means a complete tear of the rotator cuff supraspinatus tendon. The words 'very large, nearly complete with 1cm retraction of tendon fibres' are a bit concerning. Mild surface irregularity of the supraspinatus in keeping with scuffing-mild partial thickness bursal surface tearing. The orthopedic said that after 6 weeks of PT if there is pain then we looka possible surgery, is there something else that I should do or look at? Thanks for stopping by and sharing your story. However, some people will never experience the same level of recovery without the surgery. Of course, I am sure his orthopedic surgeon will be able to give good advice in this regard (after a full clinical assessment etc.). I have a feeling this is going to be a long recovery! 20. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. Rotator cuff exercises are often prescribed for people with a partial tear of the supraspinatus tendon. This may include things like having a lesser ability to detect hot versus cold on their skin in the neck region, they may also genuinely feel pain to what would usually be non-painful stimulus. I have continued to have problems with my arm and initially was told that I had a partial tear of my rotator cuff. Fehringer EV, Sun J, VanOeveren LS, Keller BK, Matsen FA 3rd. It sounds like you are on the right track with your surgeon and physical therapist. If it hasn't resolved with time, then some kind of intervention (whether physical therapy, surgery etc.) Berth A, Neumann W, Awiszus F, Pap G. Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. The supraspinatus muscle runs along the top of the shoulder blade and inserts at the top of the arm (humerus bone). For awhile I was able to get my arm somewhat back to normal but wilh slight aching. To recap I have had debridement and subacromial decompression, am 34 years old and now have arthritis, bursitis, tendinitis and impingement. Anyone want to shed a little light for a vet? Surgical repairs can be compromised when post-operative instructions are not followed, so if you have surgery make sure you know exactly what you should and should not do! You don't need to lean over as far as demonstrated in this video. Does the reverse shoulder arthroplasty and deltoid repair be a possible option of treatment? The reverse shoulder surgery is extremely involved so I am getting a second opinion. As a general principle, when soft tissues like tendons or ligaments are damaged (think sprain or strain), but are in very close proximity to one another (I don't consider 1cm retracted to be very close in this context), the structures can often heal and become as strong (or perhaps stronger) than they were before. Deciding to have surgery is never an easy decision and you may require some time to recover, but if your shoulder joint issues such as supraspinatus tear are having a significant negative impact on your life, surgery and the associated downtime and physiotherapy may very well be worth it. shoulder weakness. In general, seeing your orthopedic specialist would be an important step, these types of injuries are not likely to allow you to recover to your normal level of work functioning anytime soon without some kind of treatment. MRI states high grade articular surface partial thickness tear of the posterior spinatus tendon without retraction or atrophy. The databases to be searched include: CINAHL, Scopus, MEDLINE (PubMed), Embase, Web of Science and PEDro. This information is provided as an educational service and is not intended to serve as medical advice. Does a full thickness tear of the supraspinatus tendon need surgery It has eased the pain and amazingly shortened the length of aggravation and ache from some times days to and I'm 100% serious 15 minutes tops! It sounds like you have several concerning symptoms there. If you have been diagnosed with a partial thickness tear and begin experiencing more pain you should talk to your orthopaedic surgeon. A Guide to Supraspinatus Tendon Tears (Rotator Cuff Injury) Edwards P, Ebert J, Joss B, Bhabra G, Ackland T, Wang A. There is a delaminating tear of the supraspinatus myotendinous junction, measuring a thickness of about 2mm. 2023 The Arena Media Brands, LLC and respective content providers on this website. When I went in, he told me that after looking at my MRI, he did not think that anything was necessary, and instead wanted me to go back into physical therapy and continue to get steroid injection treatments. I will congratulate you on actually doing your exercises! It will be worth developing a good relationship with your doctor (and physical therapist) who can help you do the right things to recover as quickly as possible. Shoulder dislocation, shoulder instability, and shoulder subluxation can all coexist or happen as the result of a partial or full thickness shoulder supraspinatus tear, particularly when these tears occur as a result of trauma to the shoulder joint or acute injury. The close proximity of the supraspinatus tendon to the acromion-clavicular arch is a common contributing factor in supraspinatus tears, particularly when the tendon becomes impinged between these bone structures with activities that require arm elevation. 25. Good luck! In September '12 I had surgery to reattach both the right rotator supra and infraspinatus with excellent results. Some will have more training, experience or ability in helping patients to overcome the biomechanical factors that can cause shoulder impingement and supraspinatus tears. This will inform the development of a search strategy which will be tailored for each information source. Similarly pain and dysfunction in the shoulder may cause you to use it less, which may in turn lead to weaker muscles and tendons (which may lead to more difficulty during and after a subsequent surgery). This will help you figure out what you are deciding between. While it is true that rotator cuff tears are more common among middle aged and older people, they can indeed occur among younger people too; particularly when they are performing heavy work or have some kind of trauma event (contact sport, car accident, gym accident etc.). Thanks for stopping by and sharing your interesting story. In the mean time, I received another steroid injection treatment. In planning your treatment, your doctor will consider: There is no evidence of better results from surgery performed near the time of injury versus later on. Three techniques are used for rotator cuff repair: Traditional open repair Mini-open repair Arthroscopic repair Your orthopaedic surgeon can recommend which technique is best for you. If you give PT a go, make sure you follow their instructions and specific techniques for the exercises they give you (most likely to strengthen your rotator cuff). and seemed to be doing ok with Cortisone shots. Miller RM, Popchak A, Vyas D, Tashman S, Irrgang JJ, Musahl V, et al. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful. On one hand, I want the second opinion to be formulated entirely based on my case information (not on what another surgeon did or did not recommend). @anonymous: Thanks for sharing you story Marcia. The Arena Media Brands, LLC and respective content providers to this website may receive compensation for some links to products and services on this website. Overall, it will often take 6 months or more before the shoulder is completely back to normal. My doctor has told me I need to have arthroscopic revision rotator cuff repair. I mention this, as this will often influence treatment decisions. 2 Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, . Best to have a chat with your doctor. to maintaining your privacy and will not share your personal information without Those words exactly. 4. Pain can also be brought on by laying on . As you have correctly identified, there is quite a long recovery period following surgical repairs of rotator cuff injuries, but on the other hand, there is a pretty good success rate among people who follow the post-operative instructions. months or years after the original injury is definitely a good indicator that a further orthopedic review / opinion is warranted. If in doubt call your surgeons office. I have also been doing the pendulum exercise as prescribed and figured walking with the sling off would be no more risky to the staples. Also can I try a more Conservative approach and see a phy therapist that specializes in shoulders before any surgery. A-C joint is moderately to severely degenerative. Good luck with the recovery (I know slings can be frustrating and uncomfortable, but the weeks will pass quickly)! Studies have reported that, compared to older individuals, younger patients under 55 years have a higher ratio of smaller tears likely to occur from traumatic events.5,6 Patients over 60 have been found to be twice as likely to experience large rotator cuff tears and three times more likely to experience massive rotator cuff tears compared with younger patients.7,8 The prevalence of full-thickness rotator cuff tears may occur in up to 22% of all patients over 65.9 Approximately 25% of patients in their 60 s and 45% of patients in their 70 s suffer from rotator cuff tears.10 Patients 80 years and over have an even higher occurrence rate of 80%.8, Rotator cuff tear management aims to relieve pain, restore movement and improve function of the shoulder. Outcome of Intraoperative Injection of Collagen in - PubMed Now my left supraspinatus has a full thickness tear at the central 1/3 (AP extent 13mm?) Examination otherwise demonstrates the osseous structures of the shoulder to be otherwise unremarkable in signal and morphology. I am angry, confused and cannot get any pain relief. I hope your shoulder has now recovered! He says that my tendon is failing. Consult with your orthopaedic surgeon to determine the best solution for your case, your supraspinatus tears, any other associated injuries, and your lifestyle. Men over forty are the most likely to have degenerative supraspinatus tears. Here is some general information that may be useful. When the supraspinatus tendon is torn but not completely ruptured, usually a period of conservative management with a physical therapy program will be trialed rather than rushing into surgery. For this reason, many doctors first recommend management of rotator cuff tears with physical therapy and other nonsurgical treatments. I then went to see another orthopaedic surgeon who said I have whiplash. There are a few options for repairing rotator cuff tears. There is some spurring at the glenoid articular surface. However, in some cases it is clear that surgery is likely to be the best option. In the case of a non-retracted full thickness supraspinatus tear and acromioclavicular degeneration, surgery may well be the best option to maximize the long term outcome. This is a good example of why MRI's can be very valuable in cases like this. A rotator cuff tear is a common cause of shoulder pain and disability among adults. Full-thickness RCTs are present in approximately 25 % of individuals in their 60 s and 50 % of individuals in their 80 s; however, the reported incidence is lower for patients < 55 years of age (4-8 %) [ 1, 2 ]. At a 10-year follow-up, tendon repair is superior to physiotherapy in the treatment of small and medium-sized rotator cuff tears. If youve experienced acute damage or a recent shoulder injury, or are otherwise experiencing pain in your shoulder or rotator cuff area, consult your doctor and an orthopaedic surgeon as soon as possible, particularly if you work in a field, play a sport, or have a hobby that involves lots of overhead lifting and repetitive arm motions. For full thickness tears and more major tears (or if the tear involves more than one tendon) or there is significant damage to the tendon, various surgical procedures may be required. I was in a car accident about 18 months ago with damage to my left side of my body, stated with my fingers, to my leg and lastly my arm. Management of rotator cuff tears can broadly be divided into surgical and non-surgical treatment.8 Surgical treatments include arthroscopic repairs, open repairs, mini open repairs, tendon reconstruction and reverse shoulder arthroplasty.11-15 Non-surgical treatments consist of physiotherapy or injection. pain management and physical therapy) may be the first choice to see if surgery can be avoided. Statistical tests for funnel plot asymmetry (Egger test, Begg test, Harbord test) will be performed, where appropriate. I also have an intermediate grade partial thickness tear of superior tendon bundle of Subscapularis without retraction or muscular atrophy. These tendons have poor blood supply and will not heal themselves. Instantly a wave of incredible pain came over my entire arm, generating from the back of my shoulder all the way down to my hand. You should not feel pain in the shoulder during the movement. People who have partial thickness supraspinatus tendon tears following a fall or mechanical trauma often report similar symptoms to people with whiplash associated disorders (aka whiplash). You can partially or fully tear your supraspinatus muscle, and remember that these sorts of tears can be symptomatic (meaning they cause supraspinatus pain and inhibit your range of motion and ability to perform everyday tasks) or asymptomatic, meaning the tear is present but it not currently causing you pain or otherwise causing problems in your life. I was told that they were now wanting to do surgery to actually go in and see what they might be able to do to repair some of the damage they thought they saw. Second, I am sorry to hear about your fall and subsequent shoulder pain. Most tears are the result of a wearing down of the tendon that occurs slowly over time. My best wishes go to all of them. 5. It is plausible to sustain one or the other (or both) from a fall. If you have concerns, you could ask the surgeon when you next see him whether he thinks your symptoms are from the tendon tear and rotator cuff dysfunction or whiplash? If it has been a while since the MRI, this may involve getting another one (as tendinosis can weaken the tendon, which may in turn lead to larger tears or even a complete rupture), it may also involve a trial of PT or a referral directly to an orthopedic surgeon. There is no question that the word 'small' can be misleading regarding the amount of pain and discomfort that a supraspinatus tendon tear can cause. For many years shoulder dislocations were commonly managed by making sure the ball was back in the socket, giving a bit of ice, perhaps some anti-inflammatory medications and putting the arm in an internal rotation sling (a sling that holds the arm near the body with the elbow bent at about 90 degrees). Geary MB, Elfar JC. i was recently diagnosed via MRI that i have a supraspinatus tendon tear. There is supraspinatus muscular atrophy. The supraspinatous is one of the 4 muscles that make u. Unfortunately, I think 1cm retractions of torn tendon fibres do not favor natural healing of those portions of the tendon (without surgery). Lol. There is a moderate amount of fluid distending the subdeltoid bursa maximal over the anterior aspect of supraspinatus and the rotator interval. Needless to say, I started to feel like I was getting jerked around and not getting any realistic attention. Elderly patients; full thickness rotator cuff tear; non-surgical and surgical treatment. Information on this topic is also available as an, from the American Academy of Orthopaedic Surgeons, Nonsteroidal anti-inflammatory drugs (NSAIDs), Rotator Cuff Injuries - Clinical Practice Guideline (CPG) | American Academy of Orthopaedic Surgeons (aaos.org), When only a small part of the tendon is detached from the bone, it is referred to as a, When a tendon is completely detached from the bone, it is referred to as a, Pain at rest and at night, particularly if lying on the affected shoulder, Pain when lifting and lowering your arm or with specific movements, Weakness when lifting or rotating your arm, Crepitus, or a crackling sensation, when moving your shoulder in certain positions. Good luck! my MRI result come out that supraspinant tendom has partial tear. Your doctor should be able to explain your options and potential expected outcomes. I am sorry I can't offer you specific advice over the internet regarding surgery or specific exercises. @anonymous: Thanks for keeping us up to date. If I need surgery,what is the recovry time.. Usually getting a second opinion is not a bad option if you are not confident that the first opinion is going to lead to the best outcome for you, but I expect that may well be impossible while you are still on deployment? I worked closely with a physiotherapist for a good four months and pain got worse. Tears that develop slowly due to overuse may also cause pain and arm weakness. It seems to be a long recovery period with a great deal of physical therapy following. The specific post-surgery rehabilitation is often differs between surgeons in different regions (depending on the specific techniques they use). JBI Evidence Synthesis16(8):1628-1633, August 2018. Selected studies will be critically appraised by two independent reviewers using standardized critical appraisal instruments from JBI SUMARI. The pain is mostly in neck and shoulder blade and collar. It's very good of you to reply so promptly and clearly though. Some surgeons will prescribe a slightly different post-operative rehabilitation program depending on the nature of the injury and precise surgery performed. Unfortunately I can't give you specific advice over the internet, without conducting a physical examination etc. This may not give immediate relief, but hopefully will show some benefit within 6 weeks. If you want any further clarification just post any follow up question. This will help minimize strain on the back. that can be just as difficult to resolve as any structural injury. but can get back fairly good motion about the shoulder . In about 80 to 85% of patients, nonsurgical treatment relieves pain and improves function in the shoulder. @anonymous: Hi Donna, I am sorry to hear about this trouble you are having with your shoulder. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. All rights reserved. Good luck! Instead specific movements are required, these shouldn't cause pain while performing the exercise. I'm sure it is no surprise to you, but when someone is experiencing worsening pain with conventional conservative management like physical therapy this is also not a good sign for a speedy recovery without surgery. This degeneration naturally occurs as we age and in most cases is relatively painless. Injury to the rotator cuff is common and progression of injury typically begins in the supraspinatus tendon mostly as a result of an intrinsic attritional process that leads to partial and eventually full-thickness tearing. The rotator cuff exercises should not cause pain while the exercise is being performed. Good luck with it! There are other things your physical therapist may be able to help you with to give you some relief in the short term. After discussing your symptoms and medical history, your doctor will examine your shoulder. The tendon that seems to be most commonly affected is the supraspinatus, although it could also easily be either infraspinatus, long head of biceps, subscapularis or teres minor tendons. Went down a water slide on a mat head first arms supporting my body. This website also contains material copyrighted by third parties. Have had physical therapy for 3 weeks with pain becoming worse so physical therapist suggested to dr. MRI of shoulder. It is not very common that two orthopedic specialists would have very different opinions on what is wrong with your shoulder (although does happen from time to time). He prescribed Vicodin and arthrotec for painbut I would like to get pregnant within a year but would like to be fixed first for obvious reasons. It may be helpful to think of the rotator cuff as a group of muscles and each muscle is connected to the bone via a tendon. It may take a while to overcome your shoulder pain, and you may even need to modify the types of activities you do, but working hard to be able to return to exercise is definitely a worthwhile goal. Full thickness tears are the complete disruption of the fibers of the supraspinatus muscle, and generally require a more aggressive treatment plan and surgery. You should also move commonly used items to lower shelves or drawers or similar easy-to-access spots, since its going to be a while before you regain your previous range of movement. Questions: 1. (Left)Overhead view of the four tendons that form the rotator cuff. Are you experiencing rib pain? Additional surgical techniques not found in the previous systematic review have been added to this review. I have been saving up a couple months to cover my deductible expecting to schedule surgery. Some days later, I was called back to the VA so they could tell me what they found. That means it becomes more like fatty tissue. If you have only seen your family physician or general practitioner so far it would be a good idea to ask them about a referral to an orthopedic specialist who primarily treats patients with shoulder conditions. In some cases, surgery to repair the tendon is also required. The prevalence of full-thickness rotator cuff tears may occur in up to 22% of all patients over 65. Critical appraisal instruments are available from the Joanna Briggs Institute Reviewers Manual.26 All studies, regardless of their methodological quality, will undergo data extraction and synthesis. Many people with supraspinatus tears receive very good relief following a period of PT, but others do not. I am 55 and active, so I don't want to hurt my "golden" years, so I am not sure what to think. Methods: Patients ranged in age from twenty-nine to seventy-nine years. Had periods of pain go from the back of my shoulder down my arm like before. People who do repetitive lifting or overhead activities are also at risk for rotator cuff tears. Rotator cuff integrity, measured by direct magnetic resonance arthrography or conventional MRI. Failure to do so increases the risk of progression to a supraspinatus tendon full thickness tear. If the tendon has been completely ruptured (no longer attached), then surgery will definitely be required with some level of urgency for the tendon to be successfully reattached. Your shoulder specialist will be able to provide you with specific advice regarding your chance of recovery without surgery, as well as what to expect if you do decide to go down the surgery path. If in doubt, don't be afraid to ask Ortho doc #2 about any questions or concerns you might have. bested on all of the above. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. Your arm is kept in your shoulder socket by the rotator cuff. Modify Sport Techniques . They will be able to tell you the likelihood of a supraspinatus tear and adhesive capsulitis (or any other pathology), as well as the recommended course of action for your particular circumstance. Following the search, all identified citations will be collated and uploaded into bibliographic software or citation management system and duplicates removed. 9. prospective, randomised trial in 103 patients with a mean four-year follow-up. Of course, if you feel you cannot have an open and honest discussion about the pros and cons of surgery in your particular case with your surgeon, dont be afraid to seek a second independent opinion from another specialist. If you are seeing the orthopedic surgeon it is a good idea to tell them about therapies you have received and about your persistent pain. I am 55 yrs. This study included patients with a repairable full-thickness tear of the supraspinatus tendon size < 5 cm. The types of findings you have described are consistent with some quite substantial pathology in your shoulder. Waiting until after the delivery of your baby to re-attach the tendon may increase the chance of a poorer outcome (not to mention the difficulty nursing a newborn with only one functional arm). There is some really good information in what you have said. So in summary Tim, I would say I feel for you buddy. My pain is mostly in the bicep area and I do not have trouble lifting the arm but bringing it back down and also bringing the lower arm down when the upper arm is at 90 degrees. Did MRI of neck 1st which showed degenerative disc disease in c5-6 and c7-t1. Any thoughts on treatment for this considering previous surgery? Thanks for stopping by and sharing your story with everyone! Surgery to repair tendons generally involves a long recovery period.