Has anyone had a reverse shoulder replacement?

Donk said:
Well I'm 69 and recovering from shoulder surgery as I write this. My rotator cuff tendons were completely detached as was one bicep tendon and a tendon to the shoulder blade? was partially detached. They put anchors with sutures in them into the bone and then reattached the rotator cuff. Surgeon was great and went over everything step by step both before and after the surgery including going over arthroscopic pictures post op. He made it very clear to me I had to cool it, chill for six weeks, follow instruction including wearing a brace/sling deal 24/7 for best chance of recovery. I really got the warm fuzzy from him both before and after. The first surgeon I saw I couldn't get away from fast enough! It wasn't that he was recommending doing anything much different but his attitude about the whole deal sucked - for lack of a better term.

If you're not feeling great about what the first surgeon said or his attitude then get a second opinion. It's your shoulder and you want to know you're in the best hands possible before you commit to anything.

I will be in this brace/sling deal for a total of 6 weeks. I expect or have been told 3-4 months PT minimum after that.

My pain level was pretty high before surgery. Doc said I had and showed me pictures of "one pissed off shoulder" after surgery. He did both of my nephew's shoulders and my nephew is 100% after. I'm hoping for similar results.
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When I had similar surgery the little Donjoy Iceman classic 3 they sent home with me was a Blessing. Pain relief with out pills and the resulting constipation.
It turns out chilling increases healing.
 
I had the reverse shoulder done about 14 months ago.
pain level was low. . first night , I took a pain pill just in case., didn't want to wake up in the middle of the night after the op drugs and blockers wore of..
2nd night. took 1 pill for the same reason .. that was it for pain meds.
Rehab started about a week and went well . not pain free but nowhere near as bad as the rotator cuff that I had 10 years earlier .
I have pretty much full range of motion and after 4 months went back to playing pickleball. sometimes when playing it feels like i have a pulled muscle, but its not so painful that i cant keep playing.
I m happy with the results
 
For about 6 weeks, i couldn't reach my wallet in my back pocket .. but that was a good thing.. :)
it's not perfect but range of motion is not a problem for me , im stronger now then before and could probably improve it if I had the ambition to do so.
 
SMSW said:
I'm considering a reverse shoulder replacement - it is called a reverse because the doc saws the ball off the humerus, mills a recess that gets a metal and plastic cup, and secures a ball fitting to the scapula. This procedure is recommended for rotator cuff injuries. They no longer repair the muscles for folks over 65 for rotator cuff tears...now it is replacement time.

@Uncle Phil has had two standard replacements, opposite what I am looking at, and he has shared his experience with me. If you have had this surgery, I have some questions.

My concerns are:
What is your range of motion after surgery? I have nearly total range of motion, but no strength - cannot lift a coffee pot to pour a cup w/ my left arm. My supraspinatus* muscle is torn through and one of the tendons to my bicep is also torn. The 'lifting' function of these will be replaced with the deltoid muscle. Since the geometry changes, one's range of motion may be limited. One woman who I have spoken with said she cannot reach above her waist on her back with the arm that underwent the surgery. She can reach mid back with her other arm. This might not be a bad trade-off...there are back scratchers galore. :rofl1:
How long was recovery? A friend said if they told you it would take a year to feel 100%, nobody would go through with this unless there was major pain. I have little to no pain...just lack of strength.
How long before you started PT after the operation, and how long did the PT last?
How is your strength after the operation?

A very big part of this is having confidence in your surgeon. I've had an initial interview with one of the most highly rated shoulder guys in town. My wife, who was with me, said later that the exam room could barely contain the surgeon's ego. I felt that he minimized the potential problems and the procedure. He said the operation takes 20 minutes (I'd guess preop prep and post op recovery are not included here), he said after 2 days I 'd begin light physical therapy and be back to normal in 14 weeks. I am going to get another opinion. Fortunately, Cleveland has more than a few excellent orthopedic surgeons who specialize in shoulders, and all accept Medicare (well, maybe the guys who fix professional athletes do not).
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I have had 5 shoulder replacements, 1st two were regular replacements, developed an infection in one 5 years later and had a reverse, year later the other replacement was failing, and had another reverse replacement. Two years later both are good, the second reverse I also had a torn rotator cuff. with the reverse they said the rotator cuff is not used, so being an expert in replacements, go for it! PT was not that bad within 6 months was back riding, today I can raise both arms signaling Touchdowns! lol. Lost some strength but not that noticeable.

I'm pretty much Bionic at this point in time, two total knee replacements in the last 1 1/2 yrs, wrist fusion 20 yrs ago, left hip replacement 2 yrs ago..! Doesn't keep me from riding. The TSA agents laugh when going thru the scanner..! I refer myself as Steve Austin's little cousin, the Quater Million Dollar Man..! lol..
 
Al st1100 said:
Is this a Craftsman saw? I don't see any torque specs. :rofl1:
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Interesting. I'm scheduled for a left shoulder reverse replacement at the end of October.
This was informative. My first reaction was . . . this looks nice, all clean and dry. I'm guessing there's an additional degree of difficulty when everything is bloody, wet and slippery.
In any case, i'm encouraged by the comments of all those who've shared their experiences.

Shuey

PS: I'm thinking the anesthestist is my new best friend!
 
Shuey - The somewhat biggest surprise for me was how much upper body muscle strength I lost through the procedures.
I had both of my shoulders replaced within 90 days of each other (planned by me).
I still struggle with the strength thing 4 years later even though I do some regular light weightlifting to try to overcome it.
But the pain relief and increased mobility are well worth it!
 
I saw my doc in February, and scheduled surgery for the second week in April. I also had an appt set up for March to discuss what hardware he was going to use, and any other issues. At that meeting, he asked me what pain I had - none. He checked my range of motion - and he said it was about 90%. He asked why I wanted it, I said because I cannot hang up a coat or shirt in a closet on the rod w/ my left arm - no strength. I cannot lift and pour coffee from a pot (no strength in left arm). He checked how high I could reach on my back, and then said he would not operate on me because he did not think I would be happy w/ the outcome.

In my case, a fall tore my supra and infra spinach muscles (spinatus...but I like spinach) clear across. PT increased my strength somewhat, but, after 2 months of supervised PT and another 4 months of weight training on my own, I could still only hold a 5 lb dumbbell in my hand near my ear and then press it upward. Online series of exercises suggested doing this w/ a 25 lb kettle ball. That is how much I've lost.

My takeaway from this:
* A reverse shoulder uses the deltoid muscle to lift your arm. The doc determines the attachment point to give you the range of motion you want/need. For a golfer, this is easy. For me - I wanted strength AND mobility of a young guy - not so easy.
* A reverse shoulder op will loose you some mobility. A woman told me she could no longer fasten her bra in the back. Well, that's easy. For one I don't wear a bra, for two, if I did I'd hook it in the front and spin it around.
* A reverse shoulder op will not give you back the strength you had.
* Shoulder operations/joint replacements are GREAT at solving major pain issues, which are caused by arthritis and deterioration of the OEM joint (bones). If you have no pain, the docs are hesitant to mess with the joint.
* There is some risk with all surgical procedures. My doc said that was 1%. The Cleveland Clinic's website said for all shoulder joint replacements the risk for complications was 6%. I like the risks involved in getting vaccinations - say 1 in 100,000 or 1 in 50,000. Heck, I know 100 people who have had joint replacements so that means 5 or 6 of them had problems.
* Replacement joints are not magnets for infections. However, when I asked my doc about these he said since there is no blood supply to a plastic and metal replacement joint, any stray bacteria that might happen to land on the joint will find a safe haven to be fruitful and multiply. No blood supply means no white cells to attack the bacteria.
* I have a couple of friends here in town who have had reverse shoulder replacements and are tickled pink with the results. Neither of these two guys wears a bra so no problems there.
* Expectations are all.

My doc said to come back once a year for an MRI. If my joint deteriorates any more and I have pain, he will replace it in two years. He also said by that time they will have definitive information if robotic surgery has better outcomes than humans doing the surgery. By outcomes I got the feeling he was talking about fewer complications.

Bottom line, it is your choice. I told him he gave me back my summer (no surgery, no recovery) and lowered my BP by a good 15 to 20 points. I tend to worry about people sticking sharp objects into me (and not only a little worrying).

I wish you the best of luck with the surgery.
 
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Shuey said:
Interesting. I'm scheduled for a left shoulder reverse replacement at the end of October.
This was informative. My first reaction was . . . this looks nice, all clean and dry. I'm guessing there's an additional degree of difficulty when everything is bloody, wet and slippery.
In any case, i'm encouraged by the comments of all those who've shared their experiences.

Shuey

PS: I'm thinking the anesthestist is my new best friend!
Click to expand...
I have always considered my anesthetist to be "Dear Mr. Fantasy" (by Traffic)
 
Why would you want to put in a shoulder backwards. :rofl1: But seriously I had my hip joint replaced and had some very odd things happen afterwards. It's been over a year now and I'm fairly happy with the results. I have regained a lot of strength back but it took a long time. Be patience, stay on exercise schedule and good luck. Al
 
FWIW, What I was told by my ortho is that if the rotator cuff is torn, they usually do a reverse replace (position of ball and socket reversed).
In my case my rotator cuffs were fine so they did a 'normal' replacement.
But they still have to cut the rotator cuff to do the 'normal' replacement ... ;)
 
SMSW said:
I'm considering a reverse shoulder replacement - it is called a reverse because the doc saws the ball off the humerus, mills a recess that gets a metal and plastic cup, and secures a ball fitting to the scapula. This procedure is recommended for rotator cuff injuries. They no longer repair the muscles for folks over 65 for rotator cuff tears...now it is replacement time.

@Uncle Phil has had two standard replacements, opposite what I am looking at, and he has shared his experience with me. If you have had this surgery, I have some questions.

My concerns are:
What is your range of motion after surgery? I have nearly total range of motion, but no strength - cannot lift a coffee pot to pour a cup w/ my left arm. My supraspinatus* muscle is torn through and one of the tendons to my bicep is also torn. The 'lifting' function of these will be replaced with the deltoid muscle. Since the geometry changes, one's range of motion may be limited. One woman who I have spoken with said she cannot reach above her waist on her back with the arm that underwent the surgery. She can reach mid back with her other arm. This might not be a bad trade-off...there are back scratchers galore. :rofl1:
How long was recovery? A friend said if they told you it would take a year to feel 100%, nobody would go through with this unless there was major pain. I have little to no pain...just lack of strength.
How long before you started PT after the operation, and how long did the PT last?
How is your strength after the operation?

A very big part of this is having confidence in your surgeon. I've had an initial interview with one of the most highly rated shoulder guys in town. My wife, who was with me, said later that the exam room could barely contain the surgeon's ego. I felt that he minimized the potential problems and the procedure. He said the operation takes 20 minutes (I'd guess preop prep and post op recovery are not included here), he said after 2 days I 'd begin light physical therapy and be back to normal in 14 weeks. I am going to get another opinion. Fortunately, Cleveland has more than a few excellent orthopedic surgeons who specialize in shoulders, and all accept Medicare (well, maybe the guys who fix professional athletes do not).
Click to expand...
Well, I'm here to tell you, I've had 2 reverse shoulder replacements about 1 1/2 yr apart. The PT was about a week or so later. It's been so long but probably lasting a month or two. But most of it you can do by yourself after a month or so. the strength slowly comes back, Mobility, well let's just say I can Signal Touchdown with no issues..lol. The one arm I can reach behind back past halfway, the most recent one only can get too midway. If I wasn't so lazy to stretch that would go faster. Bottom Line. Two knee replacements, Left Hip Replacement, Two Shoulder replacements a Fused right wrist, I got lotsa Metal in me. I refer myself as Colonel Steve Austin's little Cuzzin, the Quarter Million Dollar Man..! LOL... Bottom Line is 68 yrs old and still riding! The Steed is nearing the 100k mark, 500 more mile to go for that..!

Good luck you'll feel good once its done!
 
I am working in the UK, I have not examined you, I cannot provide medical advice over the internet. I will use at times vague wording mainly because we cannot be sure which person will be the 85% that are happy, the 10% that are less happy or the 5% that are worse following their surgery. I think the system is different in the US in that here we would err on the side of caution due to not having as much capacity and also not being able to run from our complications as easily.

I have been putting in shoulder replacements for the past 6 months as part of my training. I take about 1h30 mins from the patient being positioned until I am ready to move the patient off the table, anaesthetic time is variable. My trainer who is doing most of the replacements in this region can perform it in around an hour which is the general standard here. The risks I consent for include: pain, bleeding, infection, damage to nerves and tendons, stiffness, swelling, dislocation, reoperation, implant failure due to loosening or wear, revision, fracture, clots in the legs and or lungs, heart attacks, strokes, amputation and death. We usually keep patients in for a day or two following the surgery for optimising analgesia and ensuring they are safe to be returned home.

The amount of strength and mobility following this surgery cannot be guaranteed, the main benefit will be the pain relief. If you don't have pain you have the risk of being dissatisfied that your painless joint has been replaced with an imitation joint often that is a bit clunkier/warmer/more swollen than it was before. Most of the patients take 1yr to reach the full potential of the shoulder, usually it takes about 8-12 weeks for people to start driving again and tackle most household chores. Most of the time we are doing these replacements for cuff arthropathy - people that have torn the cuff, the shoulder joint has worn and now they are struggling to cope with their pain/immobility. The often given advice is to expect to be satisfied with doing activities at the waist level, it is quite likely you will be able to do things up to the level of the shoulder, don't bank on doing things above your head, internally rotating the shoulder to reach between your shoulder blades is usually lost but most don't have that to begin with. We advise against loading the shoulder such as using it to push down when rising from a chair or using it to carry out DIY. I'd be quite taken hesitant if you wanted to push your ST1300 around with it.

Infected joint replacements are fairly uncommon but when it does happen it is a pretty big nightmare that can lead to many more operations, many months on antibiotics and the possibility of a constant smouldering infection that never truly goes away. Infection can be from the surgery itself or many years later if bacteria reach it through the blood from a chest infection, water infection or other seemingly inconsequential illness or minor injury. The other thing I haven't seen mentioned much is that the implant will wear out or loosen in time leading to failure, current data suggests implant survival is 10-15 years. There is no current revision option for a reverse shoulder replacement that I'm aware of, once the joint is worn that will be it in terms of operative management.

From my small experience and from what you have described I can't imagine you would be guaranteed to improve much with a shoulder replacement. There is a risk of making things worse, you will likely trade some of your mobility and not be guaranteed your strength. If you leave the shoulder as is the worst outcome will be gradual onset of arthritis in the shoulder which will bring pain and a reduction of movement. The treatment for that would be a reverse TSR.
 
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