Torn rotator cuff, need second opinion

Patient

Q: Shoulder has been hurting for 2 months. Had an MRI done. Report shows torn rotator cuff (images and report attached). Saw the surgeon on Friday. Here is what I was told:

1. According to MRI images this looks like a tear that can be FULLY repaired, even though it has passed 2 months after the surgery.
2. Compared to the left shoulder, the right shoulder has 60% strength. Mobility is not too different. Not too much pain. Can sleep OK at nights.
3. If patient had a medical condition other than the tear which would complicate the surgery, then in this case no surgery is an option too.
4. However, because the patient is in fairly good health, it is recommended to do the surgery.
5. If it goes not operated for another 1.5 months, the surgery won't be of much help.

Questions:
1. It has been 2 months after the injury, so far not too much pain and can function OK. Will the condition worsen over time?
2. Do the MRI images really suggest that a full (or even a partial) repair can be achieved?
3. Why do I have only 1.5 months left for a successful surgery? What will change in the next 1.5 months?

Symptoms:  Right shoulder pain
Images: 
Torn rotator cuff, need sec...-1 Torn rotator cuff, need sec...-2 Torn rotator cuff, need sec...-3
Doctor

A:   Hello.
Read about your history and your interaction with the Surgeon and the things that you were told. The points are very clear.

Based on the reports and the the points you were told I would like to answer your queries:
1. It has been 2 months after the injury, so far not too much pain and can function OK. Will the condition worsen over time?
> Since there is already 40% loss of power, the condition will certainly worsen over time.

2. Do the MRI images really suggest that a full (or even a partial) repair can be achieved?
>Yes, the MRI images suggest that the full or at least partial repair can be achieved.

3. Why do I have only 1.5 months left for a successful surgery? What will change in the next 1.5 months?
>The changes in the next one and half months can be related to the following points.
- The fibrosis in the torn tissues increases over the next one and half months that the pliability of the torn structures is lost and the repair becomes difficult and the results will not be good.

- The muscles further become weak to an extent that the recovery becomes uncertain and hence the effectivity of the surgery.
- Over the time the strength of the other muscles like pectoral, deltoid, triceps and biceps acting on the shoulder too get weak adding to the existing problem hence the surgery may not be of much help.
- There is contracture of the injured areas which becomes not reversible.
- Effectiveness of the physiotherapy is reduced.

All these factors decided the outcome of any reconstructive procedure.

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