Total reverse shoulder replacement - advice please

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Topic Title: Total reverse shoulder replacement - advice please
Created On: 04/21/2013 06:09 PM

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 07/08/2014 06:38 PM

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misty3

Posts: 132

When I had my conventional replacement, the postop xray was picture perfect. Too bad it did not last more than 2 months.

Most people are very happy with a conventional. However, the difference between that and a reverse are so vast that it is not even on the same planet. I am one of the few who has had a hemi, tsr and reverse on the same shoulder within 2 years.

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 07/08/2014 09:16 AM

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tfalk

Posts: 11

As someone with a conventional shoulder replacement, I would not even attempt rock climbing... Heck, I don't even want to climb a ladder unless I have to. Too much chance for ending up back in the OR. I have to say having the replacement was one of the best things I've done. At the same time, I was prepared to not have much use of the arm and just hoped the pain would go away... To have virtually no pain, more ROM and be as strong as it appears to be, I'm *extremely* lucky. If you opt for the surgery, you really have to stop every single time you are going to push it and question if what you are about to do is worth the risk.



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 07/05/2014 11:17 AM

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misty3

Posts: 132

I had a rather high impact fall on my elbow- collision with the back end of a horse that threw me several feet. There was a rupture of the cuff and impaction fracture of the humeral head. They dillydallied with the cuff repair, and it was done probably too late to have a decent outcome. Should be done asap, and mine was not done for 4 months. Over time the bone defect bcame arthritic (months, not years). I had a lysis of adhesions 7 months after the cuff repair, then a bicep tenodesis and distal clavicle resection a few months later. Then, i had a humeral head resurfacing done for the arthritis. He said that would last 15-20 years and was less involved than a replacement as it would save the glenoid. Well, he put it too high, plus that device should not be used if there are other issues like the injured cuff. It started wearing away the glenoid, then caused superior escape of the humeral head, and severe pain.

by then i was referred to the guru of shoulders. He did NOT want to do a reverse, but was prepared to do a cuff revision repair + total shoulder, reverse or fusion. At surgery, he determined the cuff was OK, so did the conventional replacement. It failed after 2 months, and the cuff was completely gone. It was awful. So, i went back and had the reverse. The supposed convertible stem did not work out, and he had to remove it, breaking the humerus in a couple places. Due to the multiple surgeries, the anterior deltoid is completely atrophied for good.

the fact remains that the reverse is a SALVAGE option. It is not intended for active people. It is not intended for people who want to do strenuous activities. It was developed for elderly people who do not expect to use their arm.

it is my opinion that it is being offered more and more to younger and younger people because they CAN. It has only been around 10 years here so there is no long term data. Yes it has been around in europe longer, but it is just recently that they have started lowering the age. I follow this closely, and i get the drift that even though the docs are doing them, they should not. In my opinion, if someone is serious about strenuous activity, go to pain management. The reverse is not going to give you strength to do these activities, but it may give you a sense of false security. If something goes wrong- and that may be as simple as a slip, the complication rate for revision is at least 50%. Nope, we cannot have it all. If i could turn back time, i would live with the arthritic pain and less ROM rather than the mess i have now.

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 07/05/2014 10:37 AM

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gklimber

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Thanks so much for responding to my post. I am so sorry to hear about your experience. sounds like a nightmare. Do you mind my asking what the issue was for you and why the previous replacements failed? has anyone else out there had a total reverse shoulder replacement? I am really anxious about this. I am in significant pain, but don't want to make things worse and don't want to give up favorite activities.

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 07/03/2014 11:56 AM

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misty3

Posts: 132

I had the reverse a year ago now At age 57. It is a life changer. Do not expect to do rock climbing and such. Mine was the sixth surgery, third replacement on that shoulder. It is very fragile now. I was told to not ride my bike or my horse again. My choice to take the risk. I do have better ROM as I can lift my arm 90 degrees, but have no internal rotation at all and minimal external rotation. I can touch my head. Yay. I still have significant pain and still go to a pain doc. If I had to do it over, I would not, at least not now.

my surgeon was VERY reluctant to do it. Made me see another expert for another opinion. He is one of the best in the country and world - teaches constantly. However, due to the complexity of my problem it was a disaster. I even qualified for permanent disability based on the reverse.

your arm will nwver be the same and any sport that can cause a fall is OFF the table. It might help your pain. Did NOT help mine. I will be lucky to get five years out of this. I need to use a sling just to walk 2-3 miles and an immobilizer at night. I am completely healthy otherwise, relatively fit for my age.

good luck.

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 07/02/2014 09:30 AM

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gklimber

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I am new to this forum, and hoping for advice. I have had 3 surgeries on my right shoulder, all of which failed. At this point the only option left is a total reverse shoulder replacement. However, I am getting conflicting advice. I am 58, and being told that this is very young for this surgery, as they do not know yet how long they last. One doctor said they are confident that they last for 8 years, but unsure beyond that. Another doctor feels confident that this is not really an issue. I am extremely active. I injured my shoulder rock climbing and want desperately to get back to this. In the meantime I am doing triathlons, and of course the swimming and bike riding are very painful. The pain is getting worse and old - I have been living with this for over 5 years now. But I am terrified of another botched surgery. And I want to know if I might be able to rock climb again and swim with less pain. Are there any athletes out there who have had this surgery and been able to return to their sports? What have been the experiences of people who have had this with pain and range of motion? Thank you so much to anyone who can share their wisdom with me!

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 05/09/2013 12:31 PM

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misty3

Posts: 132

I didn't realize they can undo a fusion. Interesting, and best to you. I surely hope it works out well.I am at 9+ weeks and still in a great deal of pain. I was immobilized for 6, and still use it when I go for walks, at night, and when engaged in any kind of activity. I learned the hard way that even if I don't use it actively, it is still affected by what I do (pulling weeds, brushing horses, anything really.) The pain is primarly around the fracture site. I emailed my surgeon, and apparently is going to take months to heal (bony ingrowth). This is worrisome because it is the greater tuberosity and I have absolutely no soft tissue to help hold things in place. My shoulder looks like nothing but bone - the muscle that is left is completey atrophied, the anterior deltoid just "strings." Lovely visuals - along with the "dried up leather" analogy for the cuff that was released.I think that being young in both your cases will be very helpful. You both have suffered enough already and are still young enough to bounce back.
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 05/09/2013 02:17 AM

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lulublu31

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Hi there, thanks for replying - it's good to know I'm not the only "young one". My operation was due on 30/04, but got cancelled due to a power cut at the hospital and has been rescheduled for 25/05. Before I went home my surgeon had a look at my elbow(same arm as shoulder needing replacing), because it has started locking, and my other shoulder and I have had pain in that for a while now, but thought it was due to overuse as I have not been able to use my left one. I was told I had impingement ( don't know what that is?) in my elbow and my surgeon is now worried my right shoulder is going the same way as my left, which is obviously worrying me more. Hearing your story does however make me feel a little better. Hope u recover soon and can get back to normal. Xx
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 05/09/2013 12:30 AM

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KELSEYBASSETT

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Hi, I am new to this forum, but wish I would have found it years ago! I just had a reverse replacement done about 3 weeks ago. I'm only 29, but really had no other options. My shoulder was fused back in 2009 after multiple failed surgical attempts. The fusion was completellid fire altering and I developed a lot of upper back and neck pain. I just couldn't take it anymore. Long story short, I had to have a reverse rather than a traditional replacement because after 4 years of being fused, my rotator cuff had atrophied to practically nothing. The surgery itself wasnt so bad. I was in an immobilizer for the first 2 weeks and am now in a traditional sling for 2 weeks. I start PT next week. I'm not sure if this is the regular schedule of things or if I'm on a little different schedule due to the fusion take down. I can say that though I'm still quite achy at times, I'm in far less pain than I was prior to the surgery and I'm actually able to sleep at night! I'm eager to see how much mobility I will have once the sling comes off! I know that's not too much help seeing I'm only 3 weeks out, but at leasknew know we aren't the only 'way to young' folis out there needing a reverse replacement! Good luck with your decision. I wish you the best.
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 04/22/2013 06:26 AM

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misty3

Posts: 132

I am 57 and had it done 6 weeks ago. 16 operations!!! I had 6 and that was too many! If your rotator cuff is gone you have not much choice. Best to you. I had a rough time of it as he had a difficult time removing the stem from the total replacement and i have some fractures to heal now. My surgeon is one of the best and he was reluctant to do it at y age. If you have any questions feel free to pm me. But seems you should be the expert at surgeries!
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 04/21/2013 06:09 PM

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lulublu31

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Hi there, my name is laura, I'm 31, I will be 32 on 01/05. I am very new to this forum and this is my first post, rather hoping that someone can offename some advice.in the last 4 1/2 years I have had 16 operations on my left shoulder, which has included a rotator cuff repair, a reconstruction, a partial replacement, releases ( about Moreno name a few, I injured it rock climbing while in the royal navy. Next Tuesday (30/04/13) I am having a total reverse shoulder replacement As my body is rejecting bathe material they used for the partial replacement also my shoulder is no longer sitting in joint properly as the sub scap and other muscleaware no longer working. I was wondering if anyone around my age had had thias done and if it worked as I can't find a lot information and, i have read its not recommended in "young people" ( I have read that 50 is considered young for this). I really hope someone has some advice for me as I'm worried about this operation.thankI in advance.laura
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