I'm 52-years-old and still have a few friendly games of tennis left in me. But I've got a bum shoulder with a torn rotator cuff and probably a torn bit of cartilage around the shoulder socket. I'm not super active, but I'm not a couch slouch either. Would surgery to repair the damage be helpful?

Studies show you aren't alone. More and more adults over the age of 45 are reporting shoulder injuries such as a rotator cuff tears and superior labral anterior posterior (SLAP) lesions. As you have discovered for yourself, the labrum is a dense ring of fibrous cartilage around the rim of the acetabulum (shoulder socket). It helps deepen the socket and increases shoulder stability. If the labrum is torn from front to back, it's called a SLAP lesion.

Rotator cuff tears with SLAP lesions are usually treated surgically. Many surgeons opt to do this procedure arthroscopically. It is minimally invasive and can reduce overall surgical costs with fewer days in the hospital. The surgery involves rotator cuff repair and either debridement or repair of the SLAP lesion. With debridement, the damaged, torn or frayed edges of the labrum are shaved smooth. With the repair procedure, the torn end of the labrum are sutured back in place using special anchors to hold it in place.

Patients report pain relief and improved function with either choice. But according to a recent study, the amount of improved function and patient satisfaction is greater in those who have a rotator cuff repair and debridement.

The authors concluded that in older adults minimal intervention might be best. With combined shoulder lesions (rotator cuff and labral tears), functional outcome is better when the SLAP lesion is shaved smooth rather than anchored back in place. The reason for this might be because (as has been shown in other studies), the labrum in older adults loses blood supply and has fewer new chondrocytes (cartilage cells) to replace the damaged ones.

You might want to discuss your options with the orthopedic surgeon and see what his or her recommendations are. Remaining active is an important lifestyle goal for older adults. Restoring motion, strength, and function in your tennis arm may help move you in that direction.