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← Return to Concerns after Reverse Total Shoulder Replacement
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Concerns after Reverse Total Shoulder Replacement
Joint Replacements | Last Active: Mar 6 8:00am | Replies (7)Comment receiving replies
I am really sorry to read this, you are too young to have had this kind of bad result. From the picture, it looks like your arm is almost frozen in a sling position? Do I have that right? Were you referred to Physical Therapy after the surgery, and if so have you discussed with your PT person what might be causing this lack of motion? If they are properly licensed, they should have as much knowledge about the workings of bones and muscles as doctors.
I had a reverse TSR at about 74, and my new shoulder was working perfectly by about four months. My TSR has the same range of motion now as my non-surgical arm in every direction. My only limitation is trying to reach behind my back from butt level on up, I can only reach about to my waist, no further up. Over the shoulder and back, same on both sides. From what I understand, only the frontal part of my rotator cuff was removed, and you can see the slight depression there, compared to my normal shoulder.
Prior to surgery, I had x-rays to determine the condition of the bone and cartilage, those verified I was a candidate for a TSR. Next I had an MRI and a CT scan both in one appointment to determine the condition and health of surrounding tissues. After viewing these results, my surgeon said my rotator cuff was somewhat frayed and right on the borderline for a regular TSR and he could not guarantee good long term results. He gave me the choice, and I opted for a reverse, because I did not want to go through a possible 2nd surgery in a few years. I then went back for one more special MRI which was to take measurements for a custom made prosthesis for me from the manufacturing company.
Surgery went fine, very little pain afterwards. I wore an immobilizer instead of a traditional shoulder sling during recovery, which let me unhook the wrist band from the waist velcro at times and use the lower arm freely while keeping the elbow locked to the waist. I was able to use a keyboard on a desk right after getting home from the overnight hospital stay. I have not had the outward swing problem you describe.
It does seem very odd that you would be changed from a traditional to a reverse TSR during the surgery, and I think you deserve a more detailed explanation why he chose to do that. The ball and the socket are replaced in both surgeries, so just saying the socket was worn down makes no sense. I would also try to work closely with a good PT specialist to determine why the lack of range and what can be done about it. So sorry for your bad experience.
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Thank you so much for your response! My arm is not frozen. The picture I posted is showing the extent to which I can externally rotate my left arm when my elbows are straight out. You should be able to watch a quick video clip with link below. If my elbow is straight down, next to my body, with hands at 90 degrees facing forward, I have external rotation, but the moment I start moving my elbows forward, and upward, I can't rotate my forearm outward.
SEE VIDEO CLIP HERE:
ezgif.com/video-to-gif/ezgif-1-814135dce8.mp4
My surgeon had mentioned, during my pre surgery consultation with him, that in the X-ray, it appeared that my socket was worn. He mentioned they can put in an augmented custom made piece to compensate for that.
I specifically asked if I would be getting an MRI, he said I really don't need one, because he will be better able to assess the rotator cuff while he's actually in the shoulder. Since I had no rotator cuff issues at the time, and his quick test in the office for rotator cuff strength showed it was good, I assumed there would be a standard anatomic shoulder replacement. In retrospect I should have insisted on and MRI, but he's the expert so I went with his suggestion.
turns out (from what I heard) that my socket was too badly worn, for that custom made socket piece to work properly. It only compensates for about 8 degrees of wear and mine was worse than that, so that's why they needed to do a reverse apparently.
What angers me, is why didn't the detailed CT Scan reveal this beforehand? I received literature advertising "Blueprint 3d Planning + PSI" that "creates an anatomic 3D model of your shoulder and virtually perform your shoulder replacement surgery".
If that's the case, someone certainly must have known my socket was too badly worn for a standard Anatomic Shoulder Replacement.
But I'm wondering if, and why, my reverse shoulder replacement will result in worse results with a good rotator cuff (pre surgery) than someone who had a damaged rotator cuff.
Again, I'm only 6+ weeks post surgery, but it seems I should be able to move my arm much better than I can at this point. Other aspects of my recovery are very good. I feel I could do push ups. Internal rotation seems like it was pre surgery.
I requested the "Operative Report" from the surgery (which my therapist recommended). He said he will interpret, if he can, any documented problems that arose during the surgery. I don't have an appointment with my surgeon until four months after the surgery. I think I will call and make a sooner appointment.
I'm hoping it will just take a bunch of time and hard work to get most of my motion back, but I'm really doubting it at this point. This is my dominant arm, so the prospect of having to support my dominant arm to brush my teeth as a result of the surgery is really gonna **** me off.
Thanks again for your reply!!