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Saturday, May 19, 2007

LHT Shoulder Surgery


Dad's surgery was not as successful as we had hoped. His rotator cuff had been torn sometime earlier in his life. Dr. Robert Jackson said that he was unable to repair it well because of the earlier injury. He hopes that Dad will have the same kind of use that he had before the latest tear but he was unable to get it done properly.

He performed the debridement, in which loose fragments of tendon and bursa and other debris from inside the irritated, injured and torn area of the confined space in the shoulder where the rotator cuff moves (subacromial space) were removed. He was able to make more room in the subacromial space so that the rotator cuff tendon is not pinched or irritated. He shaved bone and removed growths on the upper point of the shoulder blade (subacromial smoothing). However, when it came to sewing the torn edges of the supraspinatus tendon together to the top of the upper arm bone, he was not able to pull much of it together. He was able to pull it only one-third of the distance it should have covered.

The rotator cuff helps keep the arm bone seated into the socket of the shoulder blade. Massive tears (greater than 2-inhes or involving more than one rotator cuff tendon) often cannot be repaired and that was Dad's problem along with the age of the first tear. Dr. Jackson said that the newest tear had just added to what had been done before. He doesn't understand why, at the time of the first injury, there would not have been pain.

He said that after this surgery, if Dad still has lots of pain, grafting and patching procedures are possible, but they are not much better at restoring strength than debridement and decompression, which is less risky and requires less rehabilitation. That sort of repair is a major surgery and requires opening the area by incision. Less active people (usually those older than 60) with confirmed rotator cuff tears that do not cause pain, significant weakness, or sleep problems can safely go without that type of surgery unless symptoms become worse. In some cases, arthroscopic debridement and smoothing adequately relieves pain and restores enough function to allow daily activities, and open surgery is then not necessary.

Rotator cuff repair surgery, if successful, restores more strength to the shoulder than arthroscopic debridement and decompression alone. The more strength that is restored, the more shoulder function there is. We are hoping that he is one of those who has full motion even though he might not have former strength. However, Dad and the doctor agreed that, until he re-injured his shoulder, he was doing fine and we are all hoping that he will be restored to at leas that much function.

Love, M


Kim Pitts wrote: Please tell him that we all send our love and best wishes! We wish him a speedy recovery and will keep him in our prayers. My dad (Robert Pitts) needs this surgery, but he is refusing until the pain gets too bad.  He wants to focus mainly on getting my mom feeling better. I found a new program yesterday to help with funding for more home health care. Medicare quit paying for it. Hopefully it will help some!

Thanks for letting me know about the surgery. You all take care!
Love, Kim and kids

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