Shoulder and other joint replacement

[CfRhTxStBobcats 600]

I need both shoulders replaced at the ripe old age of 52. Doctor told me shoulder replacements are basicly shit right now and if I stay active I'll need to replace them again in just a few years. Problem is my insurance probably wouldn't pay for it again. I'm just hoping my ortho doctor is being a little overly cautious. New model just came out, but he doesn't recommend being a guinea pig. Question is, has anyone had a shoulder replaced, and what are your limitations?  I'd also like to have both replaced in the same calender year so I only pay the deductible once. From what I hear this guy is supposed to be one of the best. He works at Methodist in Houston and is one of the doctors in the group that takes care of the Texans and Astros. I'd like to still be able to hit the gym with some light weights, anyone tried it? I don't know anyone that's roughly my age that's had it done, the people I know that's had it done are older and not very active. Basicly I feel like I'm screwed either way. The pain is unbearable sometimes, but I can see myself deteriorating quickly if I have the surgeries. 

[destroya 377]

How much longer can you go without getting them replaced and have you looked into stem cell injections?  I'd do everything I could to delay a shoulder replacement.  What's your current level of activity and pain?  Has your condition been caused by overuse, injury or bad luck?

 

edit: lots of questions. not many answers. 

Edited May 29, 2018 by destroya

[CfRhTxStBobcats 600]

14 minutes ago, destroya said:

How much longer can you go without getting them replaced and have you looked into stem cell injections?  I'd do everything I could to delay a shoulder replacement.  What's your current level of activity and pain?  Has your condition been caused by overuse, injury or bad luck?

 

edit: lots of questions. not many answers. 

Overuse from my early 20s to late 40s, lots of overhead work. Any simple movement can be very painful, but I'm able to do limited movements with very light weight in the gym. It's been a learning curve over the last 6 years. It's the everyday functions that seem to hurt the most, reaching for something, standing with my arms crossed then putting my arms down, and probably the worst is sleeping. Half of the ball on my right humorus is worn down, its completely flat on one side. 

[torre 1,286]

2 hours ago, CfRhTxStBobcats said:

 I'd like to still be able to hit the gym with some light weights, anyone tried it? I don't know anyone that's roughly my age that's had it done, the people I know that's had it done are older and not very active. Basicly I feel like I'm screwed either way. The pain is unbearable sometimes, but I can see myself deteriorating quickly if I have the surgeries. 

Have you tried the pain management/physical therapy route  ?

Many surgeons will recommend those before electing surgery.     Your doctor should be able to give you a good referral.

[futureman 22,464]

yeah shoulder replacements don’t do as well as knees and hips.  I’d try every other route imaginable until the knife is the last resort. 

[Mez2 4,023]

you *can* do a shoulder replacement, if you but as mentioned above it's not going to be nearly as successful or have as great of an outcome as knee/hip replacement, hell those are now becoming an outpatient procedure which would have been unheard of just a few years ago. SX, usually, is a last option resort for many people - you'll want to do as whatever you can to avoid being cut on - good orthopedists will even tell you that, they should at least - anyway, therapy does help to a certain degree and if done correctly will help alleviate the burden your shoulders will bear down the road (modifications, strengthening, etc). 

i work with a lot of orthopedic doctors and know several of the ones on staff with the Texans, many of them will tell you that surgery/rehab is a three part process and how you take into that, ultimately, affects how you'll feel when you're finished - you the patient, the physician/surgeon, and the rehab/therapy. obviously, you know yourself but i would learn as much as you can about your surgeon and then where they'll likely refer you for OP rehab. a good PT can go a long way in your rehab. 

[CfRhTxStBobcats 600]

1 hour ago, Mez2 said:

you *can* do a shoulder replacement, if you but as mentioned above it's not going to be nearly as successful or have as great of an outcome as knee/hip replacement, hell those are now becoming an outpatient procedure which would have been unheard of just a few years ago. SX, usually, is a last option resort for many people - you'll want to do as whatever you can to avoid being cut on - good orthopedists will even tell you that, they should at least - anyway, therapy does help to a certain degree and if done correctly will help alleviate the burden your shoulders will bear down the road (modifications, strengthening, etc). 

i work with a lot of orthopedic doctors and know several of the ones on staff with the Texans, many of them will tell you that surgery/rehab is a three part process and how you take into that, ultimately, affects how you'll feel when you're finished - you the patient, the physician/surgeon, and the rehab/therapy. obviously, you know yourself but i would learn as much as you can about your surgeon and then where they'll likely refer you for OP rehab. a good PT can go a long way in your rehab. 

He gave me cortisone injections in both shoulders and sent me to PT.  After a few weeks I went back in for my follow-up visit and pretty much the first words out of his mouth were "it didn't help much did it". He kept saying I don't want to scare you, but..... you have the shoulders of an old NFL veteran o-lineman. It sounds vain, and believe me I'm no gym rat, but not being able to stay in shape after the surgery is what scares me the most. Well that and paying for the next set out of my pocket. At least right now I can do certain exercises with very light weight and limited shoulder movement, I'm afraid that will come to an end after replacement.  He said I can't do much more damage so I guess I'll keep doing what I'm doing until I can't. Luckily I have a great crew that works for me so my income isn't affected. I guess it's time to give them a hefty raise to keep them around.

 

[futureman 22,464]

have you looked into using resistance bands?  I doubt you should be lifting weights if it’s as bad as you say.  

also swimming may help the joints as well. 

Edited May 30, 2018 by futureman

[CfRhTxStBobcats 600]

3 hours ago, futureman said:

have you looked into using resistance bands?  I doubt you should be lifting weights if it’s as bad as you say.  

also swimming may help the joints as well. 

The resistance bands are what I used in therapy and still use them now and then. When I say l still lift, it's never more than 15 pound dumbbells and my elbow never gets anywhere near shoulder high. It's mostly curls, tricep pull downs, and seated  rows, lots of reps. Anything I can keep my arms in tight to my sides I'm ok, even the stretching motion of the rows isn't bad as long as I keep it light. Reaching back, overhead, or out with nothing in my hands is always painful, as is laying on my sides which is the only way I can sleep very well so I'm constantly waking up. As far as swimming goes, there's no way I could freestyle,  breaststroke, or backstroke, there's way too much motion. My shoulders crack, pop, and grind with any rotation of the joint. The therapist put it best, he said my shoulders sound like they're full of rice crispies. I'm going to snap a pic of my xrays next time I go in and post them, it's pretty fucked up looking.

 

 

 

 

 

 

[futureman 22,464]

that sucks man.  would be interested to see the x-rays.  

[SHOOTER12 8,810]

On 5/29/2018 at 11:39 PM, futureman said:

yeah shoulder replacements don’t do as well as knees and hips.  I’d try every other route imaginable until the knife is the last resort. 

There's more to look at than that unfortunately.  True, shoulders don't do as well as knees or hips and are a very complicated joint.  It took me 3-4 years to even find someone who would do mine, as most didn't want to do it when I was 58-59.  Finally found a great orthopod, but had unfortunately waited too long and the only option was a REVERSE replacement, which is pure hell compared to a straight replacement. 

My advice is hell yes get it done before it gets to the point of no return, sure wish I had.

[SHOOTER12 8,810]

On 5/29/2018 at 6:20 PM, CfRhTxStBobcats said:

Overuse from my early 20s to late 40s, lots of overhead work. Any simple movement can be very painful, but I'm able to do limited movements with very light weight in the gym. It's been a learning curve over the last 6 years. It's the everyday functions that seem to hurt the most, reaching for something, standing with my arms crossed then putting my arms down, and probably the worst is sleeping. Half of the ball on my right humorus is worn down, its completely flat on one side. 

Just saw this...get it done NOW in my highly prejudicial opinion.

No amount of therapy/rehab is going to fix that.

[futureman 22,464]

3 minutes ago, SHOOTER12 said:

There's more to look at than that unfortunately.  True, shoulders don't do as well as knees or hips and are a very complicated joint.  It took me 3-4 years to even find someone who would do mine, as most didn't want to do it when I was 58-59.  Finally found a great orthopod, but had unfortunately waited too long and the only option was a REVERSE replacement, which is pure hell compared to a straight replacement. 

My advice is hell yes get it done before it gets to the point of no return, sure wish I had.

how long ago did you have it done and how are you doing now?  a reverse is typically a revision to a standard replacement, and you’re right they are a bitch.  

[SHOOTER12 8,810]

Just now, futureman said:

how long ago did you have it done and how are you doing now?  a reverse is typically a revision to a standard replacement, and you’re right they are a bitch.  

Had it done last July.  First surgery on that shoulder, not a revision.  The recovery has been almost a year now, and over the last 1-2 months it has regressed.
Losing range of motion and pain levels slowly creeping upwards again, starting to have trouble with everyday tasks again.

[futureman 22,464]

sorry to hear that.  yeah reverses are done as primary surgeries on bad joints; I was just saying that typically they are put in as revisions.  another big problem with them is that it’s extremely difficult to revise a reverse, if it can be done at all.  try to move that joint around as much as is possible with resistance bands.  motion is lotion.  

[SHOOTER12 8,810]

17 hours ago, futureman said:

sorry to hear that.  yeah reverses are done as primary surgeries on bad joints; I was just saying that typically they are put in as revisions.  another big problem with them is that it’s extremely difficult to revise a reverse, if it can be done at all.  try to move that joint around as much as is possible with resistance bands.  motion is lotion.  

Yeah, the bands have been my go to, although I've backed off quite a bit in the past weeks due to pain levels.

[Mac8111 2,107]

Can’t speak on shoulder specifics, but Texas Orthopedic Hospital / Fondren Medical group is first class operation when you start looking at replacement.

[CfRhTxStBobcats 600]

23 hours ago, SHOOTER12 said:

Had it done last July.  First surgery on that shoulder, not a revision.  The recovery has been almost a year now, and over the last 1-2 months it has regressed.
Losing range of motion and pain levels slowly creeping upwards again, starting to have trouble with everyday tasks again.

Man, I'm  sorry to here that. At what stage did you decide to have it done? It sounds crazy, but doing light reps on certain exercises at the gym is less painful than putting on a shirt, whether it's button down or pull over, putting on deodorant, and even turning a steering wheel. I guess working out is more of a controlled moment so I know what I can do without too much pain. About half the time my wife has to help me get my shirt on, but on the bright side she doesn't like the old missionary position anymore because my shoulders crunch in her ear.  At this point are you wishing you didn't do it? I guess I definitely won't get both done the same year, it's not worth saving $4,500 If there's a good chance I'll have issues. I hope it gets better, I feel for you.

[CfRhTxStBobcats 600]

On 5/31/2018 at 1:04 PM, SHOOTER12 said:

Just saw this...get it done NOW in my highly prejudicial opinion.

No amount of therapy/rehab is going to fix that.

Crazy thing is the left isn't  worn down quite as badly, but it hurts worse than the right. I'm thinking I have a torn rotator but he said he won't do an MRI because even if it is torn he couldn't fix it because it needs to be replaced. Like an idiot, I was hurrying down the attic ladder and missed a step and reached back across the opening to keep myself from falling on my face. I tore my pec and pretty sure the rotator as well. Never been in such pain in my life. That was about 6 years ago when the pain was first starting and also when I found out I had arthritis. When that happened he told me I would have to replace them in about 20 years. Roll forward 6 years the pain gets worse, I go back in and he's amazed at how the arthritis has progressed and tells me it could be done at any time, but try an wait until the pain is unbearable. The xrays he took a few months ago were much more detailed than 6 years ago, so im not sure if the bone deterioration is that much worse or the new shots taken at all angles showed more. My Dr is John Seaberg, he was at KSF orthopedics before moving over to Methodist. I've nothing heard but great things about him and know several people that's had joint replacement and other surgeries by him. I guess it doesn't hurt to get a second opinion.

 

Damn, just looked at his bio again, he's a gooner.

Edited June 1, 2018 by CfRhTxStBobcats

[CfRhTxStBobcats 600]

Sooner or not, I agree with the reviews he received, probably 90% positive. This guy has a great demeanor and from everything I've read is a great doctor as well. 

[SHOOTER12 8,810]

On 6/1/2018 at 1:19 PM, CfRhTxStBobcats said:

Man, I'm  sorry to here that. At what stage did you decide to have it done? It sounds crazy, but doing light reps on certain exercises at the gym is less painful than putting on a shirt, whether it's button down or pull over, putting on deodorant, and even turning a steering wheel. I guess working out is more of a controlled moment so I know what I can do without too much pain. About half the time my wife has to help me get my shirt on, but on the bright side she doesn't like the old missionary position anymore because my shoulders crunch in her ear.  At this point are you wishing you didn't do it? I guess I definitely won't get both done the same year, it's not worth saving $4,500 If there's a good chance I'll have issues. I hope it gets better, I feel for you.

That post is bringing back memories...bad ones.  That is the thing that drove me crazy, extreme pain in certain motion ranges, and far less in others.  The dressing, putting on deodorant, even digging something out of my left jeans pocket were ridiculous, and though better now, still a pain in the ass(shoulder).

I had better luck putting on a button up shirt than a pullover though it was no picnic.  Also washing my hair got beyond ridiculous.  It seemed like every day I discover something else that I had to be careful doing.

Whatever you decide I wish you the best, but like I said, me waiting too long multiplied the pain and recovery many times over.

Edited June 4, 2018 by SHOOTER12

[Beveaux 6]

I got my shoulder replaced last June.  It's been a year and except for a little stiffness in the morning, I don't even notice it.  Dr. Michael Loeb with Texas Orthopedics in Austin.  I stretch in out in the morning and its good to go for the rest of the day.

No restrictions at all.  

I went thru two years of progressively more pain before I finally decided to have it done.  Dr. Loeb said it should last 15 years or more, but the procedure & materials were so new they haven't been doing it long.

I will say that I had absolutely no pain from the operation.  They tied a bag around my neck with pain killer and I kept it on for about 5 days.  Removed the needle from my neck and still no pain.  Prior to the operation, I was buying Advil by the case.

[Nice Guy Eddie 13,512]

I would be cautious when an orthopedic surgeon advises against surgery.  Maybe he’s wrong but there must be a reason that they don’t even like putting in knee replacements for those younger than 60 or 65.   I’ve always assumed that it either doesn’t last or won’t put up with the stress that a 52 year would put on it.   And as you said shoulder replacements do not seem as advanced as knee or hip. 

You can probably find a doc that will do it but doc shopping is a questionable idea. 

It sucks when your body breaks down and doesn’t let you do what could do at 30 or even 40. I used to like running but one knee appears to have stopped me at 48. 

[CfRhTxStBobcats 600]

On 6/13/2018 at 9:13 AM, Nice Guy Eddie said:

I would be cautious when an orthopedic surgeon advises against surgery.  Maybe he’s wrong but there must be a reason that they don’t even like putting in knee replacements for those younger than 60 or 65.   I’ve always assumed that it either doesn’t last or won’t put up with the stress that a 52 year would put on it.   And as you said shoulder replacements do not seem as advanced as knee or hip. 

You can probably find a doc that will do it but doc shopping is a questionable idea. 

It sucks when your body breaks down and doesn’t let you do what could do at 30 or even 40. I used to like running but one knee appears to have stopped me at 48. 

The 52 part is exactly why he doesn't want to do it yet. I believe I mentioned it before, but he said a new replacement recently came out but he advised against being one of the first to get it. What's aggravating is he said even if I have a torn rotator he can't fix it because it needs to to replaced, and that's my "good" shoulder.

I watched a replacement on YouTube. I commend you guys for going through with it. I didn't think much of it until I watched that, it's tough to watch.

 

 

Edited June 16, 2018 by CfRhTxStBobcats

[Mother mopar 3,318]

Glad I found this thread. I'm 39 and about to have a shoulder replacement done next month. I've already had 2 previous surgeries on my right shoulder. I'm not sure what to expect, thus my questions. After 6 months of recovery I'm having my left one replaced too. Not looking forward to the physical therapy afterwards.

 

I've had multiple ortho docs from cali and Florida say that I need to have them replaced. What am I in for?

 

[Rougarou 594]

On 2/9/2020 at 6:36 PM, Mother mopar said:

Glad I found this thread. I'm 39 and about to have a shoulder replacement done next month. I've already had 2 previous surgeries on my right shoulder. I'm not sure what to expect, thus my questions. After 6 months of recovery I'm having my left one replaced too. Not looking forward to the physical therapy afterwards.

 

I've had multiple ortho docs from cali and Florida say that I need to have them replaced. What am I in for?

 

How did this go for you?

I've had shoulder subluxation for decades from an old football injury and recently it's gotten harder and harder to "self-fix" and get the shoulder back in the ole joint. My GP referred me to a shoulder guy because he said I'm on the progressive path to having a full-on dislocation which is serious bad news.

[ROFL BOX 6,649]

My Mom is due to have her L shoulder done in around 2 to 3 weeks.  She's 75 & I took her to the "Pass / Go" pre-op clearance on Tuesday.

Frosty will be doing the surgery & said it's possible he will be doing a "reverse shoulder" instead of other things... won't know until he opens her up & gets in there to see what it looks like.  Normally for an obese person in her age range they avoid certain surgeries however she can barely braid her own hair due to the pain.

[Mother mopar 3,318]

How did this go for you?
I've had shoulder subluxation for decades from an old football injury and recently it's gotten harder and harder to "self-fix" and get the shoulder back in the ole joint. My GP referred me to a shoulder guy because he said I'm on the progressive path to having a full-on dislocation which is serious bad news.

Replacement took about 3.5 hours and went as well as can be expected. I had my 3 month post op with the surgeon last week and he said everything is looking good. I've got more ROM then I've ever had in all my years. Am I still limited lifting directly to the side sure but it is getting better.

Just started weight training during physical therapy and it's taxing but can definitely see and feel results. I'm going in December to have my left shoulder replacement surgery done as it is not too far behind the right one per the doc. Best decision I made, besides PRK was to have an arthroplasty.

Below is a pic a few days post surgery where swelling was at its peak.

[Rougarou 594]

I don’t understand what I’m looking at, in that photo. Not your shoulder right 

[Mother mopar 3,318]

I don’t understand what I’m looking at, in that photo. Not your shoulder right 

No, just the massive swelling from it. View is from the bottom looking up to the arm pit. Maybe it's just me but I didnt expect that level of swelling and I've had my fair share of surgeries in the past.

[Best served cold 150]

So I've got a bit of an issue that I'm hoping someone can help me with. I'm 44 and I've undergone 5 surgeries in the last 22 months resulting in 2 partial shoulder replacements and now a total hip replacement. My issue is that my new hip has now caused that leg to be 3/4" longer than my right leg. I just had the surgery this past Monday and have a follow-up on October 6, but I'm wondering at my options going forward. I have talked to the Dr's PA and she said that they will look at everything then. I first had surgery on my left hip in Nov. 3, 2020 and then my right hip was also repaired Dec. 16, 2020. 

All of my issues have been the result of arthritis with a labrum tear and bone spurs thrown in there. My internet research appears to show corrective surgery or elevator shoes as my only options. Anyone have any thoughts or experience with either?

I had my surgery in Houston with what I was told was a guy that is often used to correct others mistakes. My 4 previous procedures have all gone well, albeit with different surgeons.

[HeHateMe 885]

If you haven’t had your follow up, how do you know that you are 3/4” long?  Did your PT tell you that?  Your surgeon or the PA can measure radiographically to get an accurate number.  It is not uncommon to lengthen a leg during a primary THA, however the amount you stated seems long to me.  Stability is much more important than leg length.  If you are that long your surgeon can prescribe a shoe lift and if you eventually need to have your other hip replaced, it can be evened out in that surgery.  Wait to have the x rays confirm your leg length discrepancy though.  Physical therapist love to say shit that is way outside their lane.  Good luck.

[Best served cold 150]

On 10/1/2022 at 3:03 PM, HeHateMe said:

If you haven’t had your follow up, how do you know that you are 3/4” long?  Did your PT tell you that?  Your surgeon or the PA can measure radiographically to get an accurate number.  It is not uncommon to lengthen a leg during a primary THA, however the amount you stated seems long to me.  Stability is much more important than leg length.  If you are that long your surgeon can prescribe a shoe lift and if you eventually need to have your other hip replaced, it can be evened out in that surgery.  Wait to have the x rays confirm your leg length discrepancy though.  Physical therapist love to say shit that is way outside their lane.  Good luck.

I can actually stand on my left leg without pain so we made a mark on the wall. One with me standing on my right leg and one with me standing on my left leg and then measured the difference. I have my follow-up on the  morning so we'll see what they have to say. I have had issues with my right hip, but I don't believe that we are anywhere close to the point of replacement though. Thank you for the reply. Hopefully we get some sort of good news tomorrow 

[HeHateMe 885]

2 hours ago, Best served cold said:

I can actually stand on my left leg without pain so we made a mark on the wall. One with me standing on my right leg and one with me standing on my left leg and then measured the difference. I have my follow-up on the  morning so we'll see what they have to say. I have had issues with my right hip, but I don't believe that we are anywhere close to the point of replacement though. Thank you for the reply. Hopefully we get some sort of good news tomorrow 

Ok, don’t tell your surgeon you did that.  Politely tell him you feel long on the operative side and ask him to see if there is a discrepancy.  They can use boney landmarks and a straightedge and show you in clinic.  With a half way decent digital pacs system, they can measure it and give you a precise measurement.  I obviously haven’t seen your pre op or post op films, but I’d guess you were a little short preoperatively.  Common in an arthritic hip.  I’d also guess they left you slightly long, 2-4mm, in order to make you stable.  The result of going from a little short to a little long can leave you feeling more than a little long.  Your body will adjust if that’s the case.  Now if you are 3/4” long, almost 2 cm, ask your surgeon why he left you that long.  Maybe there is a good reason.  I doubt you are that long though…but would be interested in hearing the explanation if you are.  Your spine or back issues can also play a part if you have issues there.  Please report back and if you have your films I’d love to look at them.  You can have them burn you a copy if you aren’t satisfied with what you hear at your follow up.  Hope the recovery is going well other than the stated issues.