Concerns after Reverse Total Shoulder Replacement

Posted by fredaardvarks @fredaardvarks, Mar 3, 2024

Hello, I'm new to this forum.

I'm 55 yo, and I'm just over 6 weeks post Reverse total shoulder replacement. I am concerned. I have not contacted my surgeons office yet because I don't want to complain without more facts.

My rotator cuff and all associated movement/external rotation etc was perfect before the surgery, and now it seems it's destroyed. (please read on).

I've been dealing with bone on bone shoulder arthritis for years, (heavy weight lifter off/on over the years) and finally decided to get it done and over with ( also, now is a good time because of other life situations).

Every assessment of my rotator cuff per-surgery was that it was good. I've never had any issues with rotator cuff, very strong. So I went into the surgery, and was literally in pre-op with the understanding I was going to have a standard anatomic total shoulder replacement, with a possible need for a custom made augmented socket insert (to compensate for some socket wear). I never had an MRI pre surgery, because the surgeon said once he's in the shoulder during surgery, he'll be able to much better assess the condition of my rotator cuff.
In the recovery room after surgery, is when I hear they had to do a reverse total shoulder, because apparently my socket was so worn down . That upsets me, because why didn't the CT scan show them before the surgery that the socket was so worn? And that I was expected to have a Reverse Total Shoulder Replacement? And then, what the ramifications of that will be e.g., big loss of use of dominate arm. The facility touts they use "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, why didn't they know ahead of time that I needed a Reverse Total Shoulder.

The point is, my rotator cuff and all associated movement/external rotation etc was perfect before the surgery, and now it seems it's destroyed. Even though I'm only barely over six weeks post op, I have no external rotation with "positive elbow flexion". In other words, I can't hold my elbow straight out in from of me, with arm bent at 90 degrees. Elbow will push outward, I can't keep in near my body.(SEE PICTURE BELOW).
Even sitting straight upright, at a table, with elbows very slightly in front of me (like now at a keyboard), I have to external rotation. The surgery was performed on my left shoulder and I'm left-handed. I have to hold my dominant arm so that I can brush my teeth, shave, even eat. If that doesn't get any better, it'll be a disaster. I'm already wishing I had my arthritis back. 🙁

I will be angry if they knew ahead of surgery that I needed a Reverse total shoulder replacement, while also having a perfectly good rotator cuff, and didn't tell me that I will lose a lot of use of my dominate arm.

Again, I'm sure people will read this and say ....."hey you're not even two months post surgery, give it time to heal", ......but other aspects of my recovery (Active range of motion) are going very well and this external rotation thing is not at all. If it was going to improve, I would think it would have started improving by now.

I'm hoping that somebody here who has had a reverse shoulder replacement can address external rotation ability. Again from my perspective, my rotator cuff was perfect. I had no limitations whatsoever, and now I'm afraid the use of my dominant arm will be much worse than before the surgery. I am making very quick recovery in all other aspects.

attached is picture of left arm. Can't move it outward. It's not because it's sore, it's just there is nothing there to move the arm.
Seems doubtful it will improve but looking for feedback.

Thanks all

Interested in more discussions like this? Go to the Joint Replacements Support Group.

bobt8 | @bobt8 | Sep 2 5:23pm

In reply to @JustinMcClanahan "Hi @bobt8, I moved your discussion into another discussion titled: - https://connect.mayoclinic.org/discussion/concerns-after-reverse-total-shoulder-replacement/ Here, I wanted to..." + (show)

The surgeon I am seeing is indeed the same surgeon who said that there was nothing more she could do. She performed 4 rotator cuff, bicep tears and AC joint surgery prior to the RTSR on my right shoulder. She also performed 2 surgeries on my rotator cuff, bicep tears and AC joint repair on my left shoulder. Why would I return to the same surgeon who performed a total of 7 shoulder surgeries prior? Simply put, the additional surgeries were caused by falling, 20 minutes of CPR and more falls. Lumbar fusion L4-S1, multiple knee surgeries, severe neuropathy in my feet and lower legs and 6 pelvic fractures from a 60mph head on collision has caused my lack of balance to have significant impact on staying upright.

I do (amazing as it may sound) trust her skills as a surgeon and if she doesn’t feel there isn’t anymore she can do with additional surgery, I will search out a second opinion. The humerus was broken in two during that accident, just below the replacement shoulder and wasn’t surgically repaired because as one doctor stated “the priority was keeping you alive” during my 5 month stay at a trauma center in ICU.

Medically I have a very complex and complicated history, 2 induced comas, 2 life flight rides, many hospitalizations from dog bites (my dogs) to vfib and diabetes complications. In the last 36 years I have had over 50 surgeries and 2 months ago was diagnosed with bladder cancer.

It’s made it very difficult to list prior surgeries in the one inch space on new patient paperwork.

I wish I had made all this up as it’s been very difficult maintaining a positive outlook.

myracorbo | @myracorbo | Sep 2 10:42pm

I’m not sure if you are addressing me with your question. I did get a second opinion but I knew beforehand it would be the same, reverse shoulder replacement. Unfortunately I will have to have surgery on my opposite shoulder, osteoarthritis.

kobesnowy | @kobesnowy | Sep 3 6:44am

In reply to @myracorbo "I have the same problem. Did you find out what was causing this?" + (show)

So so I and I had the RSS on June 25

myracorbo | @myracorbo | Sep 3 3:16pm

In reply to @kobesnowy "So so I and I had the RSS on June 25" + (show)

Rotator cuff tear(s) and osteoarthritis. The reverse replacement is due to rotator cuff tears,
I had my surgery on 1st August or September 2024. Not sure of the month.

kobesnowy | @kobesnowy | Sep 3 5:55pm

In reply to @myracorbo "Rotator cuff tear(s) and osteoarthritis. The reverse replacement is due to rotator cuff tears, I had..." + (show)

I’m sorry that made no sense. I was talking into the phone.

I had reverse shoulder done on June 25 and my range of motion is not great although I could now brush my teeth and wash my hair

I still have pain in the bicep area and my armpit, and I also ended up with fluid in my arm, which is pain

Just hope all goes away soon

myracorbo | @myracorbo | Sep 3 7:56pm

In reply to @kobesnowy "I’m sorry that made no sense. I was talking into the phone. I had reverse shoulder..." + (show)

Before the replacement I played lots of tennis. Well I’m back to playing tennis. My serve isn’t as fast as it was before the surgery, but was expected.
ROM will slowly get there.
I’m sorry to hear you are having pain. What did the doctor say what the cause of the pain?

kobesnowy | @kobesnowy | Sep 4 4:13am

Thank you

Good for you to get sick to tennis ❤️

I cannot get an answer to be honest

This is the problem

rochelle14 | @rochelle14 | Sep 4 5:22am

Hi …When I was a teenager my left shoulder would pop out of socket.I would hang my arm down in miserable pain,until it popped back.Now it hurts like hell ,sometimes it feels stuck.the left shoulder has a tear ,doc says I’m too young for a rotator replacement.Can’t comb hair correctly .cause my arm can’t raise.I pray your shoulder gets better

rochelle14 | @rochelle14 | Sep 4 5:26am

In reply to @bobt8 "The surgeon I am seeing is indeed the same surgeon who said that there was nothing..." + (show)

I understand.Don’t give up on yourself.try to do the best you can .Listen to your body.Move through your pain as much as you can.I live through this pain.And ask my higher power to help me.GBU

afm | @afm | Sep 4 8:24am

In reply to @myracorbo "Before the replacement I played lots of tennis. Well I’m back to playing tennis. My serve..." + (show)

Good to hear that you are able to play tennis again and can serve overhead. When did you have the replacement done? I had a right shoulder rTSR on 5/1/25. I just received the go ahead to start working up to playing again after my 3 month X-Ray looked fine. Hitting some balls thrown to me now and plan to start rallying next week. No pain so far. The goal is to start playing in November. I was playing 4 -5 times per week last fall but had to quit due to my ankle which was replaced 12/18/24. After I stopped playing tennis my shoulder which was okay (got a bit sore occasionally) locked up and became painful. Tennis kept it loose and pain free. ROM is very good - mostly working on behind the back now. Good luck to all.