Shoulder Surgery AGAIN but unsure this time.

[Run262]

I've had 3 shoulder surgeries in as many years - all three on the right shoulder for instability. The third surgery worked like a charm, an open capsular shift. Since this last surgery, which was a about 2 years ago, my left shoulder started hurting - it started during the recovery phase of the 3rd surgery - compensating for loss of the right arm I imagine. Over the past 2 years, it has come and gone. About 3 months ago, I was playing on the monkey bars with my 5 year old (showing off) and ended up hanging suddenly using only my left arm and felt something pop/pull severly. Since that time, the shoulder pain has gotten worse and I'm showing signs of a torn/partially torn subscapularis - all tests are positive, waiting on the results of the MRI.

MY QUESTION (FINALLY): The 3 prior surgeries I had on the rt. shoulder were all soft tissue type surgeries, as in no anchors/screws of any nature, no work on the rotator cuff - and the recovery wasn't too bad/too painful at all.

I've heard rotator cuff surgery is a very painful recovery -  I imagine from whatever anchor hardware is used and drilled in to the bone to secure the repair.

I'm just looking for an honest answer...is it a different "ball game" pain/recovery wise? I'm just so done with shoulder surgeries and to have this come up really has me taken back. To think of having yet ANOTHER shoulder surgery makes me sick, but I can't live like this - I've tried PT and anti-inflammatories but nothing really works - it really needs to be fixed I guess. Ugh.

[Run262]

Nice hearing that it's probably not as I imagine. Interesting note however about the subluxation - it did sublux, didn't dislocate and it has been looser since, but not much of a problem since I'm right handed and find I'm not using the left arm as much due to the pain from the subscap. Yes, I had a nerve block for the last surgery - that was nice, but the placement was a bit of a challenge for the dr at the time (I seem to have been the only case he had a problem with). I've also had the pain pump as well for the first 2 surgeries.

Thanks for your response - it's been a great help

[Michael L Gross, MD]

Quite the contrary.  The use of suture anchors has allowed for smaller incisions, eventually leading to arthroscopic repairs. In addition, repairs using suture anchors are generally more secure which generally allows for less post operative pain and faster mobilization and quicker recovery.  By the way, a partially torn subscapularis may not require suture anchor repair at all, an arthroscopic debridement may end up being all that is needed. Given your history of instability in the opposite shoulder, and your mechanism of injury, I would be worried about a shoulder dislocation or subluxation which was accompanied by a subscapularis injury.
Finally greater attention is now paid to postoperative pain management, including the use of nerve blocks, and intrarticular delivery of analgesic agents.