What surgery would you recommend for my complex shoulder condition?

What surgery would you suggest: Diagnostic Imaging Report PATIENT: PARSONS , GRANT ELLIOT UNIT#: 0001498559 Magnetic Resonance Imaging Accession MR-25-024470 2025/09/25 13:30 MR Shoulder, Unilateral Non Enhanced -EX Report MRI LEFT SHOULDER: TECHNIQUE: Routine unenhanced shoulder MRI. COMPARISON STUDY:X-rays 7/6/2021 FINDINGS: Patient states history of shoulder surgery approximately 2 years ago. There is a clinical history provided of dislocated shoulder December 2024. Pain and reduced range of motion since then. Sequences have been modified in an attempt to decrease susceptibility artifact from prior surgery. There is still expected susceptibility artifact in relation to the prior rotator cuff repair. AC JOINT: Features of partial AC joint resection with mild widening of the joint. Small volume joint fluid. Minimal bone marrow edema anterolateral acromion. SUBACROMIAL BURSA: Moderate volume of fluid and mild synovial proliferation identified in the subacromial/subdeltoid bursa which is freely communicating with the glenohumeral joint on basis of a large fullthickness re-tear of the posterior superior rotator cuff. See below. LONG HEAD OF BICEPS: Medially dislocated from bicipital groove. The tendon is identified appearing contiguous with the biceps labral anchor and 06-Oct-2025 11:44 AM, ADT Dr. Bobby Rajan CONFIDENTIAL: DO NOT DISTRIBUTE. Page 1 of 2 PARSONS, GRANT 0013059225 CA-NS Diagnostic Imaging coursing through the anterior aspect of glenohumeral joint. The tendon is suboptimally profiled though mildly indistinct along the extreme superior medial margin of the joint. Split tear cannot be excluded. POSTERIOR SUPERIOR ROTATOR CUFF: Prior rotator cuff repair with 2 anchors identified associated with greater tuberosity. Complete full-thickness retear of supraspinatus and infraspinatus tendons. High riding humeral head abuts the undersurface of deltoid. There is medial tendon retraction of supraspinatus tendon 4.5 to 5 cm, to glenohumeral joints and more posteriorly, medial to the glenoid rim. Infraspinatus tendon is retracted nearly 6 cm, close to the spinal glenoid notch. There is severe fatty atrophy of the infraspinatus muscle belly. Moderate fatty atrophy of supraspinatus muscle belly. Teres minor muscle and tendon are maintained. SUBSCAPULARIS TENDON: Completely torn with ill-defined debris along its expected lesser tuberosity insertion. Muscular humeral attachment is mildly edematous though grossly contiguous. Severe fatty atrophy of the muscle belly. GLENOHUMERAL JOINT/OTHER: High riding humeral head as described. There does not appear to be a Hill-Sachs deformity. No high-grade or full-thickness glenohumeral hyaline cartilage defect identified. Small glenoid rim and inferior humeral head osteophytes. Synovial proliferation identified along the posterior superior aspect of glenohumeral joint and throughout axillary recess. Mild edema and fatty atrophy localized along the mid to anterior deltoid musculature.