Irreparable Rotator Cuff Repair with Latissimus Dorsi tendon transfer

[nielboy]

Hi Everyone,

I’m new to posting on the forum but have been a lurker for several years.

I thought I’d post this to see if anyone on the board has had a similar surgery and what the long term outlook has been for you.

I have an irreparable rotator cuff that can’t be repaired using the conventional methods.
I’m facing a decision on whether to opt for surgery to repair this massive rotator cuff damage involving Latissimus Dorsi tendon transfer.

For some background, I’ve been lifting weights since my late teens and am now in my mid 50’s.

In 2011, I suffered partial thickness tears of the infraspinatus & supraspinatus tendons of the left shoulder back in 2011. After a consult with a sports medicine doctor he recommended physio and exercise to rehabilitate the shoulder.
I got all of my previous strength back in the shoulder during the years that followed but had occasional discomfort which I simply attributed to age.

In July 2019, I had a wipeout while tubing behind a boat in a lake. The impact of hitting the water was right on my left shoulder and resulted in immediate pain. Subsequent Ultrasounds & MRI determined that I had really buggered up my left shoulder including:
-full thickness tears of both the supraspinatus & infraspinatus tendons
-moderate tendinosis of the long head of the biceps
-degenerative/fraying posterosuperior labral tear
-because of the previous tears in 2011, I now had severe retraction of the supraspinatus & infraspinatus tendons which would make them irreparable by conventional means.

It took until this January 2020 to get an appointment with an orthopedic surgeon in my city.
In the meantime, I have been able to (through exercise) gain about 90% of my range of motion back. I’ve been working on my strength and have made progress across the board on my left side including:
-military press - empty handed only to sets of 20 with a 15lb dumbbell.
-push-ups (not wide grip though)
-biceps dumbbell curls – empty handed only up to 30lbs
-side lying dumbbell rear delt rise – empty handed only to 5lbs
-dumbell front raise – empty handed only to 5lbs
-standing dumbbell fly – empty handed only to 5lbs
-I’m also doing recommended lighter weight dumbbell exercises to develop the front deltoid and teres minor to help them compensate for the tendon tears.

The pain has been very manageable to the point that I’ve stopped taking the NSAIDs for inflammation & pain.

So back to the appointment with the orthopedic surgeon. He told me that he’s never seen the amount of damage as he’s seen with my shoulder rotator cuff. He was surprised that I had the range of motion, strength and minimal discomfort that I stated to him.

He said my current status would not remain and would deteriorate exponentially in the coming years. He recommended surgery sooner than later to help remedy the situation. He said I would never gain my full strength back in my left shoulder but would have full range of motion and be pain free. The surgery he recommended was Rotator Cuff Decompression & Repair along with possible biceps tenodisis and latissimus dorsi tendon transfer.

This surgery has me really worried about positive outcomes. I don’t have the option of the regular tendon repair because the tendons had atrophied so badly and retracted and were all but useless. He advised me that if I waited, that in 5 -10 years I would regret it with the increased pain and loss of use of the shoulder but it would be too late to repair by then. At that point I’d have to wait until I reached 70 yrs old to have the reverse shoulder reconstruction.

The surgeon is highly respected and I trust his judgement but the use of the latissimus dorsi tendon is “robbing Peter to pay Paul” type of surgery.

So has anyone had this type of surgery and if so how did you make out. I know from the surgeon that the re-tooling of the Latissimus Dorsi tendon does have an impact on the back….how significant I don’t know.

Thanks

[tkdnj]

my story was (and is once again) much like yours. I had EXTENSIVE rotator cuff and bicep tenodesis surgery 5 years ago in 2015. I had full tears and partial tears in in the infraspinatus & supraspinatus tendons of my right shoulder requiring 6 anchors in my rotator cuff and a double anchor for the bicep tenodesis. I am scheduled to have similar surgery in the other shoulder February 28. I am also in my 50's and have been lifting weights since my teens. I documented my recovery from the 2015 surgery here: https://forum.bodybuilding.com/showt...hp?t=167304741 . It should answer many of your questions. I was back lifting weights in 4 months (light and strict), but took about 18 months to really feel perfect (which it still feels like today). In a few weeks I start it all over again on the other shoulder. Good luck!

[BrickB]

I can't imagine how much stress you've put on it but if this helps, I had shoulder/rotator cuff issues for 3 years and I stopped everything and it went away, I can lift moderate weights now and it doesn't bother me.

[nielboy]

Hey Guys, thanks for the feedback.

tkdnj, I'll make sure to have a read through the thread where you documented your recovery.

I'm getting a second opinion because going ahead with this surgery.