Let’s talk shoulder replacement

Matt414
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St. Petersburg , FL US
Who’s had a total shoulder or Humeral head replacement done? I had surgery for the second time on my shoulder back in November and doc that did it said I need a replacement now. I’ve seen 5 different docs and they all say the same thing. That I need a replacement. I am looking into maybe just doing a humeral head cap if its worth it. I am worried about how much function I am gonna lose with a full replacement. And it seems they are good for 18-20 years, I am 38 now, so doesn’t sound like fun doing it again around 60. But I am completely miserable in pain with it now.
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Falcon
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Menifee, CA US
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8/4/2021 4:54pm
Never had any replacement, but I did have a surgery to repair the tissues after too many dislocations. What was your original injury/injuries? Have you been having pain since the November surgery?

I feel for you, man. Shoulder pain sucks. If it were me, I'd see if I could heal up a little longer before going down the replacement route. Then again, I don't know how bad off you are.
Matt414
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St. Petersburg , FL US
8/4/2021 6:58pm
Falcon wrote:
Never had any replacement, but I did have a surgery to repair the tissues after too many dislocations. What was your original injury/injuries? Have you been...
Never had any replacement, but I did have a surgery to repair the tissues after too many dislocations. What was your original injury/injuries? Have you been having pain since the November surgery?

I feel for you, man. Shoulder pain sucks. If it were me, I'd see if I could heal up a little longer before going down the replacement route. Then again, I don't know how bad off you are.
Second surgery. First was 20 years ago after dislocating it 40-50 times. This time was to remove a bunch of lose bones pieces that broke off from being hit by a car. And they did a bunch of work reshaping the humeral head and cleaning out the calcium deposits.

I figure if it’s not better by now, it’s probably not getting better. The surgeon that worked on me said this is what it is. And new one I saw last week said same thing. He took one look at my X-rays and said it’s worst looking shoulder he’s ever seen of anyone that can move their arm. And he’s surprised I am as functional as I am.
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ProKawi24
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Herald, CA US
8/4/2021 7:23pm
I don't think mine are as bad as yours but I can relate. I was paralyzed back on 01, broke my back, arm & wrist, some ribs, sternum, and busted my left shoulder all to hell. The docs were so worried about my back and sternum they kinda brushed off the other injuries. My arm was all casted up, ribs you can't do much with (plus I was bed ridden for a month anyways). It was the year after during rehab that my shoulder gave me a lot of trouble. I had 2 more back surgeries and 2 more arm surgeries so the shoulder again was pushed aside. I kept over-compensating with my right side which caused problems later. I later found out I had a complete tear of the left rotator cuff and bicep tendon. Had 2 surgeries in 5 years to fix those. Then had major trouble with the right side from over-compensating and had 2 more operations on the right side. Pushing a wheelchair all day doesn't help and continues to cause issues for both shoulders. I've had numerous cortisone injections but I guess you can only get so many before it can become toxic to your body.

The docs want to do another operation on each shoulder but they still can't guarantee anything will be permanently fixed. Plus I have a full time job, my wife works full time so I can't have her always helping me in and out of bed, my truck, the bathroom, etc. for months until I'm fully recovered. I was told the same thing, I could do a full replacement on both and should be good for 10-15 years (since I use them so much for my chair) but for me I can't take the time off needed to fully recover. I've found a lot of relief in rubbing Volteren cream on both shoulders every morning and night instead of taking pain meds or crapping blood from so much ibuprofen. Getting massages every 2 weeks really helps too. Icing them down if you have a real busy day will help the short term.

Unfortunately with major shoulder injuries there doesn't seem to be a solid 1-stop cure all. Luckily since Covid my work has gone mostly remote so I don't need to lift into my truck every day anymore which helps a lot and not pushing around at the office all day. Hope you get better dude, shoulder pain IMO is even worse than back pain.
nytsmaC
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Frig Off CA
8/4/2021 11:52pm
When I shattered my humerus head in 2018 the doctors were unsure if my bone would heal or die, so the possibility of a shoulder replacement was looming over me. Everything about it just sounded awful and it terrified me. Luckily I got bone growth and so far so good, but I do have to get x-rayed every year to monitor it and I’ll never he totally out of the woods, as arthritis and increased pain will be waiting for me as time ticks on.

I can’t offer any insight, just sympathies. I learned more than I ever wanted to know about shoulder replacements and I know how dreadful it is.
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The Shop

8/5/2021 3:03am
I have.
I have had two TSA (anatomic) in 2019 and both failed immediately due to glenoid component loosening. Last year doctor removed the second failed joint and I now have a cement spacer awaiting a custom reverse joint. Yes - four replacement surgeries in span of two years on same shoulder.
The pain you are having is 3 out of 10. The pain of a poor/failed joint is 50 out of 10.
You are too young for a TSA. I recommend hold out as long as possible. If you get it, make sure you have a stable joint. The cap may not provide stability if your glenoid is deformed in any way.
I'm 58 years old and super healthy. Prior to my first TSA joint replacement I had several arthroscopic joint clean outs.
Get a joint replacement and your moto days are done, period!
Any more questions lmk.
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LoudLove
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US
8/5/2021 4:59am
Over a decade ago I experienced a complete humerus fracture and shattering of the humeral head. Multiple consultations with shoulder repair surgeons all led to the same conclusion: do not opt for shoulder replacement surgery unless absolutely necessary. If the pain is manageable w/o medication and you have a decent range of motion, work around those issues.

I have about 60% range of motion, but more importantly, experience little pain. The bone tissue died years ago but I can still ride off-road and mountain bikes. Even rather significant nerve damage, which led to muscle atrophy, has not been a huge issue. I simply worked around it knowing that you can’t go back once replacement surgery has been performed.

To recap: if you’re simply considering surgery, don’t do it.
Wandell
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Cairo, GA US
8/5/2021 6:57am
My 74 year old mother in law had total shoulder replacement surgery a few months ago. I thought it was an insane decision due to her age and inactive lifestyle! However, she has amazed me. She is still going to physical therapy twice a week but doing great. The family is constantly having to remind her not to attempt to lift stuff with it. Orthopedic surgery is advancing at an amazing rate!
grunkster
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Rochester, MN US
1/8/2022 2:21pm
So even with advanced osteoarthritis and at 61 you guys are saying do NOT get it done if I wish to keep riding... right? I am able to sleep at night with it but have already been on meloxicam for 10yrs plus. At what point would you know you MUST get it done? I hate how it crackles and pops when I do things
1/9/2022 8:40am
I had total anatomical replacements done for both shoulders during the past year. So far Im pain free and have excellent mobility so really glad i did them. Im 68 and put it off as long as I could but like you was not able to sleep and had a lot of pain. I had the first done 12 months ago, the second 7 months ago and have put in about 600 miles of EMTB on intermediate level trails since the surgeries, Im just starting to ride again, some very lightweight MX and some trail riding and so far no stop signs. Hope this helps, its a tough decision.
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nytsmaC
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1/9/2022 10:49am Edited Date/Time 1/9/2022 10:50am
grunkster wrote:
So even with advanced osteoarthritis and at 61 you guys are saying do NOT get it done if I wish to keep riding... right? I am...
So even with advanced osteoarthritis and at 61 you guys are saying do NOT get it done if I wish to keep riding... right? I am able to sleep at night with it but have already been on meloxicam for 10yrs plus. At what point would you know you MUST get it done? I hate how it crackles and pops when I do things
I guess when the pain becomes too much to bear on a daily basis.. Mine sounds like I’m making popcorn when I’m brushing my teeth, definitely have reduced strength and mobility but usually no pain these days, just some discomfort. I’ll never forget what a bad experience recovering from both shoulder surgeries were and I’ll avoid another one at all costs. You’ll know when it’s time and it won’t be an easy decision.
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1/9/2022 11:45am
grunkster wrote:
So even with advanced osteoarthritis and at 61 you guys are saying do NOT get it done if I wish to keep riding... right? I am...
So even with advanced osteoarthritis and at 61 you guys are saying do NOT get it done if I wish to keep riding... right? I am able to sleep at night with it but have already been on meloxicam for 10yrs plus. At what point would you know you MUST get it done? I hate how it crackles and pops when I do things
When the pain becomes unbearable. TSA results are generally good. I have yet to meet or hear of anyone getting back to motocross with a shoulder replacement.

The last couple times I raced moto i was crashing in the corner entry braking bumps due to sharp arthritis pain. I knew at that point I had pushed my shoulder to the limit. I hope some people can get back to mx with a shoulder replacement.
My opinion is these joints just are not built for that kind of activity period.

I'm having my fourth shoulder replacement in a few weeks. Two failed immediately and now have a spacer waiting for a custom fit, 3D printed joint. May want to ask your doctor about these new custom fit joints if you want the best outcome.

What Charlie said ...... it's a tough decision.

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LoudLove
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1/9/2022 12:24pm
Almost all shoulder replacement decisions revolve around pain management. If living with no or minimal pain, the decision is easy. Surgery to improve range of motion is a crap shoot and could easily result in greater discomfort and margin ROM gains.

Above all, find a local expert and listen to their advice. The Carroll Clinic, a world-leader in joint therapy and pain management, says surgery should be the last option. Shoulder injuries are the worst and often life-altering, but avoiding the knife should be the primary objective.
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nornevrder
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Reno, NV US
1/9/2022 12:31pm Edited Date/Time 1/9/2022 12:43pm
I am 43 and have severe arthritis and about 65% mobility in my right (dominate) shoulder. They said I need a full replacement but will not do it due to my age and activity. They told me I would wear it out in 10 years. I just stretch and do the gym thing even though they discourage me from any presses. I have learned to work around my limited ROM and am far from crippled. Pain is also manageable for me.
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wildbill
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Christmas Valley, OR US
1/9/2022 12:41pm
In 2004, I swapped at a high rate of speed throwing me backwards off the bike. My shoulder then slammed into the face of a whoop splitting the scapula with a 1" crack right through the middle of the socket. After hardware in, then hardware out (after scraping my numeral head flat), the pain steered me towards replacement. My surgeon said "Don't fuck this up, I can't repair it again!" I heard him, loud and clear.
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JustMX
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TN US
1/10/2022 6:15am
Following this thread carefully.

I appreciate all input and experiences.

I tore my rotator back in September and after looking at my mri the doctor told me a reverse shoulder replacement was my only option to recover much rom and strength.

I still work everyday and am learning to adjust. One of the hardest things is using an impact driver anywhere above chest level, but dealing with that.

I have pain when I push it to far, and have trouble getting comfortable to sleep but am debating if a want to go ahead with replacement in the fall or wait until later in life.

Again thanks for sharing your experiences and knowledge on this subject.
1/10/2022 6:45am
My best advice is find the right surgeon. If I hadn’t found somebody that I had absolute confidence in I wouldn’t have done it. Do your research, talk to their patients and ask some of the surgery nurses, thats the bare minimum. Good luck.
nytsmaC
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1/10/2022 11:01am
JustMX wrote:
Following this thread carefully. I appreciate all input and experiences. I tore my rotator back in September and after looking at my mri the doctor told...
Following this thread carefully.

I appreciate all input and experiences.

I tore my rotator back in September and after looking at my mri the doctor told me a reverse shoulder replacement was my only option to recover much rom and strength.

I still work everyday and am learning to adjust. One of the hardest things is using an impact driver anywhere above chest level, but dealing with that.

I have pain when I push it to far, and have trouble getting comfortable to sleep but am debating if a want to go ahead with replacement in the fall or wait until later in life.

Again thanks for sharing your experiences and knowledge on this subject.
It’s only been a few months, work your ass off with physiotherapy and get the most of it that you can, avoid surgery unless absolutely necessary.
Mit12
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Lake Havasu City, AZ US
1/10/2022 11:18am
Both my shoulders are junk from this brutal sport. I take the Can Am X3 out for a day and my left shoulder hurts for the next 5 days! I am pushing off surgery as long as I can, as the outcome is not always better.
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grunkster
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Rochester, MN US
2/15/2022 6:36am
The Dr. Matsen invented "ream and run" procedure sounds like THE ticket for dirtbikers/MTB...imo
Timo
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Wichita, KS US
2/15/2022 8:11am
If you decide to get it done, don't let your local yocal doctor who has done a couple of them preform the surgery. Search for a doctor who has done hundreds of successful ones, and travel to them. If they're out of network, first curse our fucked up health care system, and then call them and workout a payment plan. You want someone who knows what they're doing.
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plowboy
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Norwich, KS US
2/15/2022 12:32pm
Timo wrote:
If you decide to get it done, don't let your local yocal doctor who has done a couple of them preform the surgery. Search for a...
If you decide to get it done, don't let your local yocal doctor who has done a couple of them preform the surgery. Search for a doctor who has done hundreds of successful ones, and travel to them. If they're out of network, first curse our fucked up health care system, and then call them and workout a payment plan. You want someone who knows what they're doing.
Damn straight Timo. Every time I see a new doc...I tell them straight up...I don't expect you to know everything...but I ain't fucking around. You tell me you've seen it and fixed it or you write me a referral.
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JAFO92
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BFE, TX US
2/15/2022 12:43pm
This is all good reading here. My shoulders are both toast from a lifetime of abuse along with bad arthritis. This time last year had to have a scope job on left side to clean up floating cartilage and while they were in there they did a bicep tenodesis. Took 11 months before that tendon screw site quite hurting, but it will flare up with over use. Shoulder surgeries hurt like a mofo.

I still do weekly abduction, flexion, internal & external rotation stretch sessions to keep ROM close to normal, but even then its not easy.
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grunkster
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Rochester, MN US
2/19/2022 10:27am
Well I found out ream and run is a 2 YEAR recovery...not sure I’m up for that
DG 125 Racer
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Moreno Valley, CA US
2/19/2022 10:45am
Both of my shoulders have been replaced.

Left shoulder was a humeral head replacement 11 years ago.

Right shoulder was total, anatomical replacement 3 years ago.

Range of motion improved on both, because I had massive calcium deposits on both humerous'.

Pain and function wise (after healing) the total shoulder replacement is far superior to the humeral head only. However, you need to ask your doctor what kind of lifetime restrictions they recommend after each procedure. It's likely that they will recommend more stringent restrictions with total shoulder replacement. So, that's the tradeoff.
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