Would like others experience on Reverse Total Shoulder Replacement

I am 73, and my right rotator was damaged probably 2o-ish yrs. ago. After enduring that discomfort for years, an exploratory surgery revealed that it could not be repaired - atrophy and shrinkage made reattachment of what looked like 2 frayed pieces of nylon rope impossible. I had pretty much gotten used to the soreness and flair-ups whenever I abused it by doing things I shouldn't, but finally decided, after a gazillion Triamcinolone injections over the years, to get it fixed in Oct. 2020.
The doc is one of the best in the eastern region and does only shoulders. He's also the Sports Medicine doc for WVU athletics. Things went swimmingly, and it was wonderful to have no pain. I didn't even have therapy - just some exercises, which I did religiously. My range of motion was good even before the surgery and even better after.
Then, 4 mo. in, things just didn't feel quite right in there. I reached up high one morning and heard a sound like a pencil breaking and felt pain. I went to see doc immediately, only to find that x-ray showed nothing. I knew better, and in a couple days I was back at WVU (a 4 hr. drive) this time for a CT scan. It showed a displaced fracture of the acromion. Bummer! A couple weeks later, I underwent an Open Reduction and Internal Fixation, which is a medical term for basically putting it all back together with screws and a band bridging the break. That was followed by a few weeks in a sling. It wasn't the same as before, but it was decent. I went back for a checkup about a month after that only to find that the band had broken and the end of the acromion had dropped somewhat, not surprisingly. Gravity will do that! This rendered the band and all the screws you see here absolutely non-functional. When I asked about removing them, and the broken band, he said "Don't poke a bear! The surgeon had never seen this happen before - and he has done literally hundreds of both RSRs and conventional shoulder replacements. The really interesting outcome of all this, though, is after the band broke, and even though the bone breakage had not completely healed, the shoulder felt better - not so "bound up".
We have done nothing else except check ups since that time, and you will see the ugly x-ray below.
SO: My advice to all is that if you have osteoporosis really bad don't do this unless the pain becomes absolutely intolerable. If you do not, you will be fine. I've read many clinical studies, and the thing that seems to be constant is that osteoporotic patients have a higher rate of acromion breakage and RSR failure than those who don't. I a not a surgeon, but I have researched this pretty well. Bottom line: I have been on Reclast for a few years now and my bone loss has stabilized, but I don't think I'd do it again knowing what I know now . . .
Don't let me scare you away from it though, but proceed cautiously if you have significant osteoporosis. Be well !!!

Thank you!!! I am 73 and getting ready to have the same surgery on my right shoulder. Also using a well-known "shoulder specialist" who performs 100s of these operations a year. While in his office the other day another patient had the EXACT same issue as you--a fractured acromion post surgery! My pain is unbearable at this point, so I'm going thru w the surgery. Thank you so much for posting. Lin

I am 73, and my right rotator was damaged probably 2o-ish yrs. ago. After enduring that discomfort for years, an exploratory surgery revealed that it could not be repaired - atrophy and shrinkage made reattachment of what looked like 2 frayed pieces of nylon rope impossible. I had pretty much gotten used to the soreness and flair-ups whenever I abused it by doing things I shouldn't, but finally decided, after a gazillion Triamcinolone injections over the years, to get it fixed in Oct. 2020.
The doc is one of the best in the eastern region and does only shoulders. He's also the Sports Medicine doc for WVU athletics. Things went swimmingly, and it was wonderful to have no pain. I didn't even have therapy - just some exercises, which I did religiously. My range of motion was good even before the surgery and even better after.
Then, 4 mo. in, things just didn't feel quite right in there. I reached up high one morning and heard a sound like a pencil breaking and felt pain. I went to see doc immediately, only to find that x-ray showed nothing. I knew better, and in a couple days I was back at WVU (a 4 hr. drive) this time for a CT scan. It showed a displaced fracture of the acromion. Bummer! A couple weeks later, I underwent an Open Reduction and Internal Fixation, which is a medical term for basically putting it all back together with screws and a band bridging the break. That was followed by a few weeks in a sling. It wasn't the same as before, but it was decent. I went back for a checkup about a month after that only to find that the band had broken and the end of the acromion had dropped somewhat, not surprisingly. Gravity will do that! This rendered the band and all the screws you see here absolutely non-functional. When I asked about removing them, and the broken band, he said "Don't poke a bear! The surgeon had never seen this happen before - and he has done literally hundreds of both RSRs and conventional shoulder replacements. The really interesting outcome of all this, though, is after the band broke, and even though the bone breakage had not completely healed, the shoulder felt better - not so "bound up".
We have done nothing else except check ups since that time, and you will see the ugly x-ray below.
SO: My advice to all is that if you have osteoporosis really bad don't do this unless the pain becomes absolutely intolerable. If you do not, you will be fine. I've read many clinical studies, and the thing that seems to be constant is that osteoporotic patients have a higher rate of acromion breakage and RSR failure than those who don't. I a not a surgeon, but I have researched this pretty well. Bottom line: I have been on Reclast for a few years now and my bone loss has stabilized, but I don't think I'd do it again knowing what I know now . . .
Don't let me scare you away from it though, but proceed cautiously if you have significant osteoporosis. Be well !!!

Thanks. Yes, I do have osteoporosis. Have to get left shoulder and right hip also replaced. Reaching behind seems to be a common issue among neighbors. Reaching to L-4 is pretty low. Was this an anatomical or reverse placement device?

Hi @hamilton50, thank you for your post. I am 73, as well, with osteoporosis. I've been on alendronate nearly three years. I just thought I had torn rotator cuff, but an Xray showed my shoulder is eroded from arthritis. A shoulder replacement was recommended. Not easily done because I'm caregiver to my husband with Alzheimer's Disease. The PA said I am one tough cookie because my shoulder is "horrible."
She gave me a steroid injection - which hasn't made much difference. My pain is mainly in the tendon and sometimes the bicep, and flares up when I use my arm too much. I can usually get by with two 325 mg of acetaminophen and an occasional ibuprofen daily. I started using a very good infrared heating pad on the shoulder and arm at night and that really helps. Just added a magnesium cream to that which lessens the pain.
To your post, I read an article on NIH which said those on alendronate experience more fractures after shoulder replacement surgery probably because alendronate creates brittle bone.
@linamend, I hope your surgery goes well. Can you keep us updated on your progress?
Take care,
Teri

Hi @hamilton50, thank you for your post. I am 73, as well, with osteoporosis. I've been on alendronate nearly three years. I just thought I had torn rotator cuff, but an Xray showed my shoulder is eroded from arthritis. A shoulder replacement was recommended. Not easily done because I'm caregiver to my husband with Alzheimer's Disease. The PA said I am one tough cookie because my shoulder is "horrible."
She gave me a steroid injection - which hasn't made much difference. My pain is mainly in the tendon and sometimes the bicep, and flares up when I use my arm too much. I can usually get by with two 325 mg of acetaminophen and an occasional ibuprofen daily. I started using a very good infrared heating pad on the shoulder and arm at night and that really helps. Just added a magnesium cream to that which lessens the pain.
To your post, I read an article on NIH which said those on alendronate experience more fractures after shoulder replacement surgery probably because alendronate creates brittle bone.
@linamend, I hope your surgery goes well. Can you keep us updated on your progress?
Take care,
Teri

Thanks! That's why I went OFF alendronate! 😅 No thanks! And statically, there has to be 8 people taking it before it helps 1. Forget the medical term for the stars.

Hi Teri:
Some advice based on my experience:
!. Have the surgery. The pain will eventually get unbearable.
2. If you have no heart/kidney problems, ask your doc to put you on Celebrex 200mg. a day to start, up to 400 mg. if needed, and trash the ibuprofen/tylenol. I can't imagine life without it the last 25 years! I've also had finger joints replaced and have arthritis in my back, wrists and fingers. Not good for a guitar player!
3. Ask about Reclast rather than Fosamax, Fosamax is really hard on your stomach, especially taken with ibuprofen. Additionally, if it's causing bone loss it's doing exactly the opposite of it's purpose!
4. Ask your doc about Voltaren emugel gel 2.3grm. I use it on my hands/fingers. You can only get it in that strength from Amazon through Germany or Canada.
PS- If your rotator cuff is indeed intact, you might be a candidate for a conventional shoulder replacement rather than a reverse. Ask.
Good luck,
hamilton50