You fucking BJJ guys. I've never heard of this procedure. We'll have to ask.
Rip, I’m a 52YO male, 5’10 @ 235#. I’ve been training for > 10 years and my pre-injury lifts were SQ: 495, DL: 575, Press:198, Bench: 330.
Two months ago I injured my right shoulder training BJJ. The original injury happened during a light pummeling drill—nothing violent or seemingly traumatic at all. I thought I had popped a few fibers loose from muscle-tendon junction. So a did a Starr rehab for a week and eased back into training. I re-injured the shoulder almost immediately. I repeated this cycle a couple more times until I decided maybe to stop being a dumbass and go visit the ortho.
Ortho gets the MRI report and says I have massive RC tear involving both infraspinatus and supraspinatus tendons with retraction to the AC joint level and atrophy of associated muscle bellies. He thinks he can reattach them, but needs to perform the surgery soon before even more retraction occurs.
If he can’t reattach them, he plans to use a ballon implant in the subacromial space. As I understand it, this is a new technique for massive RC tears with promising results. But it’s a biodegradable implant, and I have no idea what happens when the implant dissolves in 18 months.
Moreover, I finally read the radiology report for myself and it mentions “diffusely irregular appearance to the labrum favored to represent labral tear rather than prominent degeneration and fraying”. My ortho didn’t say anything about about fixing a labral tear—just the RC tendons.
My gut tells me I should get a second opinion. But perhaps I’m being a back seat surgeon. What do you think?
geoff
ps, here is summary from radio report
IMPRESSION: 1. Full-thickness tears of the supraspinatus and infraspinatus tendons with retraction as above. 2. Severe AC joint DJD. Mild glenohumeral arthritis 3. Diffusely irregular appearance to the labrum favored to represent a labral tear rather than prominent degeneration and fraying. 4. Swelling and edema with fluid along the soft tissues and muscles. 5. Bursal and joint fluid probably with small loose bodies, debris or synovitis changes.
You fucking BJJ guys. I've never heard of this procedure. We'll have to ask.
Hi Geoff,
I am sorry to hear about your shoulder injury. Based on what you have told us, I would agree that a second opinion could be useful. The balloon procedure is fairly new, and while the information I have read on it is encouraging, I have not personally treated anybody who has it. The balloon is typically recommended in cases when there is a large tear that is not considered repairable. If your orthopedist is confident that they can successfully repair your rotator cuff, then you should probably go that route. Also, regarding your labrum, a guy your age is bound to have multiple abnormalities on MRI (as noted in the impression you shared: GH joint arthritis, irregular labrum, DJD of AC joint, etc.). It is entirely possible that the labrum tear has been there for awhile and is unrelated to your symptoms. Regardless, if you do go the surgical route, it is highly likely that the surgeon will debride your labrum (if not repair it) as well as clean up your AC joint a bit too.
I hope that helps.
Thanks John, thanks Rip. I was most worried about the ortho not mentioning the labrum. John's comments put that fear to rest. The ortho was confident he could repair the RC if done soon--the balloon is plan B. I think I prefer plan B to a total reverse shoulder replacement or sewing me back up as is.
Thanks again. And I'll be staying off the BJJ mats for a while, maybe indefinitely.
An update: Ortho was able to reattach everything so no ballon implant. He also debrided the labrum and repaired a bicep tendon tear that I wasn’t aware existed. Looking forward ( not really ) to starting the ring rehab you detailed as part of your shoulder recovery here in a couple of weeks.