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100% after surgery? Well...

zon said:
So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?

Good Links on AC seperation: eOrthopod
and Sports Medicine
that's why I elected NOT to have surgery because my case was such that there wasn't a huge tear in there and I never read that, even after surgery, my shoulder would be 100%. So I elected to just PT my way to 90% (or thereabouts) and skip the surgery and recovery.
You know, getting dinged bigtime results in unwanted changes in your body. We like to think we're invincible but gravity teaches us otherwise!

Rotator cuff tears and seperated shoulders are two different animals. Maybe surgery is the better way to go in your case, I don't know. My point is: do a lot of research on your own (the internet will provide a ton of info for you--I did my research at a medical school library) and see what percentage of folks who had the surgery that you need actually said, f!ckin' ay, I'm glad I had that surgery! Weigh up the cost of surgery, the recovery time and the chances that the end result will be better than just PT alone.
 

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xcguy said:
that's why I elected NOT to have surgery because my case was such that there wasn't a huge tear in there and I never read that, even after surgery, my shoulder would be 100%. So I elected to just PT my way to 90% (or thereabouts) and skip the surgery and recovery.
I think it's really a case by case basis...probably a lot depends on how bad the separation was. And then you have to take into consideration what you expect after the injury...I mean most of us here didn't get our injuries from rolling off the couch while grabbing another beer! I know I asked my Ortho that I needed to be close to 100% just to fit my lifestyle. Unfortunately the PT only got me to 75-80% after a year.

Mine was a "100% Grade 3 separation", which depending on what you read, is the worse you can get with out breaking the skin. I had also had a grade 2 from football, so I'm sure that did not help my recovery just due to the scar tissue already in there.

On the superficial side I think I would go with the scar instead of a big protruding bump that you can even see under a tight shirt.

Cons are you never know what you're going to get when someone starts cutting you open!

I would get a couple of opinions and get some realistic advice about what kind of recovery you can expect with your particular injury.
Good Luck!
 

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Grade 5 Here

Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.

I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.

Good Luck
 

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zon said:
So I will never be 100%. That sucks. Is the surgery you describe the standard procedure for this injury if elected?
My ortho said there are two types of surgery;
The first is where they put a screw in. He said this type has a high rate of failure, limits range of motion and has common impingment problems.
The second was the one I described where they take a peice of hamstring (I later found out you can opt for a "cadaver" donor) drill holes in your clavicle and scapula and basically "tie" them back toegether.
 

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StrangeLuv said:
Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.

I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.

Good Luck
Wish I had found your second guy...Which surgery did you have? The Weaver-Dunn drill and tie one?
 

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StrangeLuv said:
Separated my shoulder in 2001. It was a Grade 5. First doctor said it was a grade three and didn't want to operate. Got a second opinion. He said two things. First: you look at a how old and active the person is... a young active person should get a grade 3 fixed. Second: I had a grade 5 and needed an operation anyway.

I got the surgery and the shoulder is 100%. I have full range of motion and do whatever I want. Unless you fall, mountain biking isn't even a consideration for it. Weightlifting and wakeboarding put far more stress on it... but they don't bother it either. I highly reccomend the surgery. The bump goes away with the surgery.

Good Luck
_______________________________________
You have a good ortho surgeon...bottom line don't curse the pain... respect the pain...
 

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Just win baby!
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I had the Weaver-Dunn surgery. My shoulder works fine, with full range of motion. I only have about 90% of the strength I used to have. It has been a year and a half since surgery. I still experience some pain when doing certain things.

I gave up lifting weights because my shoulder fatigues too fast and throws everything out of wack when benching, doing lateral raises, push-ups, etc... I have no problem at all with riding and doing what needs done on the bike.
 

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NoWake said:
My ortho said there are two types of surgery;
The first is where they put a screw in. He said this type has a high rate of failure, limits range of motion and has common impingment problems.
The second was the one I described where they take a peice of hamstring (I later found out you can opt for a "cadaver" donor) drill holes in your clavicle and scapula and basically "tie" them back toegether.
Don't like the idea of weakening the hamstring. Are there rejection issues with a cadaver part? Are there any rejection drugs involved?
 

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I have a grade 3 AC separation that's a little different as it's secondary to an extremely severe "crushing blow" fracture of the last 2 inches of my clavicle as the result of a car cutting me off on the road bike. Had to have a plate put in to restore clavicle, that's good, on my 3rd month of PT, been fully released to activity.

Here's what I've found. The shoulder works great for any ride of easy to moderate effort including 10-plus hour days doing a 2-day MTB race with my girlfriend at an easy pace. When I put forth my full effort for the first time in a 38 mile technical MTB race in early November, it hurt- a lot- for the next 4 days. It just couldn't handle the 4 hours or so of hard effort and rock gardens. I've got an appointment next week with my doc that's to determine if I'm going to get the second surgery- if there's any chance it going to give me back that 10% to be able to go all-out, I'm going for it.

Don't know if any of that helps, Mike
 

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zon said:
Don't like the idea of weakening the hamstring. Are there rejection issues with a cadaver part? Are there any rejection drugs involved?

I had a variation of the Weaver-Dunn. The doc used all synthetic material to tie me back together. From what I can understand, any surgery that uses the same basic technique to tie things back togheter is generaly called a Weaver-Dunn. I don't know if that's true or not, just my take on it. I do know that when I went back for check ups, the assistent would talk into a recorder and say he was checking patient # so and so's progress on Weaver-Dunn shoulder surgery.
 

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Surgery

I think I had the Weaver Dunn. I can't remember. The second guy didn't give me the surgery. It was a third guy. I'm in the Air Force and they sent me to a specialist who only did shoulders. The first guy wanted to do it, but he said he only had done three of these type of surgeries in two years. The specialist said he did about 25 surgeries a month, but only 5 of those would be ac separations. I told him "your'e the man". He did a great job. I didn't really do any physical therapy. The doc told me to use it normally for awhile. 6 weeks later (I think, maybe 9), he cleared me to lift weights. I started out light and slowly worked my way up. The only time I notice any soreness out of my shoulder is when I lay off the weights and come back, but even that seems to be dissapating.

The sooner you can get the surgery done the better. There are three ligments in there. Two are small and one is big. It must be left over from our tree swingin' days. The two little ones had been torn all the way through and had reabsorbed due to the fact there was too much time between the accident and surgery. The big one was still good. The doc said the shoulder would be as strong as it ever was, so don't worry about it.

Keep the faith
 

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So I just had a screw removed after having it in for 3 months to heal my Grade 5 injury. I still have a bump...you can see a lot of my clavicle, in fact. Will this go away with increased muscle up there? I feel like the surgery wasn't done well. Check out the picture and see my before and after shots. Incidentally I was road biking when this happened...got clobbered by an out of control biker that sent me into shock and knocked out a couple of teeth. I'd be really curious to hear what people thought of how it looks, because I don't see why you couldn't fully fix this injury.
 

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I can't believe how many of us there are.

Im in the midst of all of this right now too. Grade III AC sep. I have to admit that Im a terrible patient. I injured the shoulder in 8/04 (yes, a year and a half ago). I tried anitinflammatories at first with no result. Kept riding. As time went on the pain increased so we went to cortisone shots (3 this year), results lasted approx 5 wks on each) then back to the pain. Kept riding. Its gotten so painful now that I began getting serious about surgery (I didnt want to be off the bike before so I said no). Well, the MRI revealed some unpleasant news. The arthritis (swelling and inflamation) in the AC joint has caused enough impingement that I have caused a nearly full thickness tear in the rotator cuff. Im sure riding contributed a lot to that as well. I know have numbness and tingling in the arm and hand and have only been able to ride light xc (normally I ride a lot of skatepark and urban as well as light FR). The pain is constant, I dont sleep well and I can't do many everyday things. I am on prednisone and PT and will be having surgery very soon.

The point to all of this rambling is....listen to the doc. Take things easy and get better. Surgery is a very reasonable alternative if you can't get thigns calmed down in a more conservative manner. Just don't follow my course of action. In hindsight, I wish I'd have been a better patient. Hopefully, the recovery won't be terribly long for me (although Im not really that optimistic). Im sure the bump will remain and that's okay since it will remind me of what I should have done (my wife and kids already do!).

Good luck man, take care and get well. Keep us posted on your progress.
 

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I'm getting the Weaver-Dunn using a cadaver tendon. My understanding of the risk wth cadaver tissue is only if science misses a bloodborne pathogen such as Hep B or HIV. Doctor said it was like the kind of odds in the Powerball, so I'm going to keep my hamstrings, thank you.

Given this will be my second and third surgeries (second to get plate removed, see previous post and third to tie it all back together) I'm feeling a bit down, but hopefully the overall picture will be good in the end.

Mike
 

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Mike Brown said:
I'm getting the Weaver-Dunn using a cadaver tendon. My understanding of the risk wth cadaver tissue is only if science misses a bloodborne pathogen such as Hep B or HIV. Doctor said it was like the kind of odds in the Powerball, so I'm going to keep my hamstrings, thank you.

Given this will be my second and third surgeries (second to get plate removed, see previous post and third to tie it all back together) I'm feeling a bit down, but hopefully the overall picture will be good in the end.

Mike
shouldn't my bump be gone though? I'm guessing you're an expert in all of this after 3 surgeries and it just seems really simple to me, looking at my X ray that the screw could have gone down further and made me heal better. I'm really wondering why they didn't. My doc is really lax with this stuff too (Harvard doc at MGH so he knows what he's doing)...he didn't even think I needed physical therapy after the screw came out last week (??)
 

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Your repaired Grade 5 looks just like my unrepaired Grade 3. So yes, I would think the lump should be gone. Get a second opinion.

Mike
 

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Mike Brown said:
Your repaired Grade 5 looks just like my unrepaired Grade 3. So yes, I would think the lump should be gone. Get a second opinion.

Mike
Thanks very much. Man this bums me out. I've been through so, so much with this.....and to think he may not have done it as well as he could have really kills me.....
 

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Mike Brown said:
I'm getting the Weaver-Dunn using a cadaver tendon. My understanding of the risk wth cadaver tissue is only if science misses a bloodborne pathogen such as Hep B or HIV. Doctor said it was like the kind of odds in the Powerball, so I'm going to keep my hamstrings, thank you.

Mike

Will you have to take any anti-rejection drugs?
 

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Late update

Ok, 9 months later. Shoulder, well it will never be the same, but pretty good considering. Pain/random pain pretty much gone. Riding well, but the more techy stuff was physically difficult for a few months with the injury. Road (yes) riding helped get me back. Took a while to get the strength back for pulling up, drops, jumps, etc. Definitely ride a tad bit more cautious/sane these days. And heck, I think my golf swing has improved from the injury, but I don't have time for that - MUST RIDE!
 

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Just be glad button fly jeans went out of style. :D
I did the same thing skiing back in the 80's. The first Q the doc asked was,. "Does it hurt to button your pants?". When I said that it did, and added "like hell", he correctly diagnosed it, before the xrays or MRI.
 
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