PCL4- prognosis

Rotator cuff tear

-People with a rotator cuff injury typically recover well with treatment. However, it's common to injure the same shoulder again, especially if you do not change the way you use your shoulder. Elderly people are prone to rotator cuff problems and have a harder time recovering because their shoulders have a less robust blood supply.

If the tear is small, a prolonged period of rest, lasting 4–9 months, may relieve symptoms. Range-of-motion exercises are also recommended, unless they cause significant discomfort. If this fails to control the symptoms, surgical repair of the tear is recommended.

Rehabilitation lasts from 6 months to a year with gradual exercise progression needed to restore normal, or near-normal function, and strength. This varies with the tear size repaired and type of surgery performed. Typically, immediately after the procedure, passive motion and isometric strengthening exercises start, along with elbow, hand, and grip strengthening exercises. At 6 weeks, the athlete may be able to begin low-intensity active strengthening exercises against gravity. The goals are to bring the athlete to normal strength with a functional, pain-free range of motion.

Yet some individuals with a partial-thickness tear have persistent or recurrent symptoms. If a conservative program of exercises and gradual return to activity does not lead to steady improvement, then further diagnostic evaluation with ultrasonography, MRI, or arthroscopy may be helpful. Arthroscopic debridement of the abnormal cuff may promote healing in athletes with partial-thickness posttraumatic tears. Following debridement, immediate resumption of range-of-motion and muscle-strengthening exercises begins. Typically, it requires 6–12 months for a throwing athlete to return to athletics following arthroscopic debridement of a partial-thickness rotator cuff tear.

Rotator cuff tendonitis

If rotator cuff tendonitis is adequately treated, there can be complete recovery.

If treatment of any rotator cuff problem is delayed or inadequate, it can lead to the affected person being cautious about moving their shoulder because of pain. This means that the shoulder can stiffen up and can lead to adhesive capsulitis (frozen shoulder)

Most people recover full function after a combination of medications, physical therapy, and steroid injections. For patients with tendinitis and a bone spur, arthroscopic surgery is usually successful in restoring them to their pre-injury level of activity.

Shoulder dislocation

Nonathletes have a 30% recurrence risk with nonoperative treatment, and athletes have an 82% recurrence risk with nonoperative treatment.²⁷

If the dislocation was the patient's first, recurrence rates with nonoperative treatment depend on age, as follows:

• Patients aged 1-10 years have a 100% recurrence rate.
• Patients aged 11-20 years have a 27-95% recurrence rate.
• Patients aged 21-30 years have a 40-79% recurrence rate.
• Patients aged 31-40 years have a 40-72% recurrence rate.
• Patients aged 41-50 years have a 0-24% recurrence rate

Complication of shoulder dislocation include the following:

• Bankart lesions in 80-89% of patients
• Anterior capsular insufficiency in 74% of patients
• Hill-Sachs lesions in 67% of patients
• Inferior glenoid labral tears in 51% of patients
• Glenohumeral ligament insufficiency in 50% of patients
• Partial or complete rotator cuff tears in 13% of patients
• Dysplastic glenoid in 13% of patients
• Biceps tendon lesions in 12% of patients
• Brachial plexus injuries in 11% of patients
• Posterior glenoid labral tear in 11% of patients
• Axillary nerve injuries in 8-10% of patients
• SLAP lesions in 8% of patients
• Partial subscapularis tear in 8% of patients
• Loose bodies in 5% of patients

Shoulder separation

Prognosis is dependent on type of injury. Course of recovery is often prolonged if surgery was required.

• Type I and II injuries usually have good to excellent results with return to full function in 1-3 weeks. Some individuals may have persistent pain or dysfunction. A small percent may need eventual surgery for degenerative disease of AC joint.

• Type III injuries usually return to full function in 6-12 weeks. Most patients treated conservatively have excellent functional outcome. Younger patients and heavy laborers may need surgery to prevent muscle fatigue and discomfort and difficulty lifting due to the displacement. Type III injuries may develop impingement symptoms, muscle discomfort and neurovascular symptoms. Late surgery may be required. Surgical outcomes can be acceptable in more than 90% if treated appropriately.

• Type IV, V, and VI generally require surgery and return to play depends on healing and restoration of near normal strength.

complications of shoulder separation

• Loss of reduction of the clavicle (does not stay in proper position)
• Clavicle fracture
• Infection
• Painful scar
• Deltoid/Trapezius muscle detachment

Frozen shoulder

• Most cases will resolve on their own or with physiotherapy over a 1-3 year period, however it is a slow recovery process
• Most patients who have a frozen shoulder will have slight limitations in shoulder motion, even years after the condition resolves. However, this limit in motion is minimal, and often only noticed when performing a careful physical examination. The vast majority of patients who develop a frozen shoulder will recover their functional motion with therapy and stretching alone

· Treatment with therapy and NSAIDs will usually return the motion and function of the shoulder within a year. Even if left untreated, the frozen shoulder can get better by itself in 18 - 24 months.

· Even if surgery restores motion, you must continue physical therapy for several weeks or months afterward to prevent the frozen shoulder from returning. Treatment may fail if you cannot tolerate physical therapy.

Possible Complications

• Stiffness and pain continue even with therapy
• The arm can break if the shoulder is moved forcefully during surgery

BURSITIES

The condition may respond well to treatment, or it may develop into a chronic condition if the underlying cause cannot be corrected.

Possible Complications

• Chronic bursitis may occur.
• Too many steroid injections over a short period of time can cause injury to the surrounding tendons.