Stemless Shoulder Replacement How to find the right surgeon

[BusterBeans]

Had a great OS for BTKR and first THR. Thought I did due diligence in selecting new OS in new location to do my second THR but he did what I consider a terrible job despite his great resume and reviews. After shoulder injections and arthroscopic surgeries to remove bone spurs and arthritis, I’m bone on bone on both shoulders and only sleeping about 3 hours a night due to soreness and pain. The 5 bad discs in back don’t allow me to sleep that long on my back either. I had hoped to delay either shoulder replacement for at least 3 years, but the right shoulder is just too painful, and I have trouble dressing and undressing myself.

The OS who did my shoulder arthroscopic surgeries does not do replacements but one of his partners does. I’ve not been able to learn much about his partner. Can anyone give me suggestions on choosing a great OS for shoulder replacements? My location and insurance carrier will be limiting factors as half of the nearby surgical practices and hospitals are owned by an insurance competitor. Thanks for your help.

 

[Josephine]

Oh, I do wish I could help you but I'm in the UK and don't know anything about US surgeons. I'm so sorry.
I would just advise you to look for an upper limb surgeon who has done around 15 or 20 shoulder replacements in this last year.

As for the pain, I found a TENS machine to be of inestimable help with that. But you need a two channel device so you can put electrodes on both shoulders if necessary.

 

[Jamie]

I may be able to help you find someone. Give me your city location and how far you would be willing to travel. Also, since you think insurance will be a problem, let me know who your insurance is with and I'll check that out as well as I look for surgeons. Be sure and tag me when you provide the information or send it in a PM.

 

[BusterBeans]

Jamie, I’m sorry but I didn’t see you response until just now. Wish I had cause I had kept looking all this time. About 3 months ago I lifted something a little too heavy and antagonized my 2 cervical discs. My family doctor sent me to a pain management center for a series of injections and ablation. The anesthesiologist/pain Mgmt doctor told me both of my shoulders needed to be replaced too after he examined me. When I shared my inability to find a shoulder replacement specialist who took Aetna and whose hospital accepted Aetna, the doctor said he had a perfect match for me who was only a 45 minute drive.

The shoulder specialist is highly regarded. Says he will do a bone-sparing replacement because he believes I will need to have a reverse replacement in another 15 or so years. We’ll do the right one in January and the left when i’l ready. I’m not wild about the hospital’s general reputation but the surgeon says he has an experienced shoulder team there that is far better than those at the higher rated hospital. He said I need to talk to the hospital anesthesiology but to count on general plus a regional. I have real problems with general due to prior immune reactions so I’ll have to have a discussion and special testing. But looks like we’re a go.

Am looking thru my wardrobe to see how many button down shirts I might need to get. Luckily I have a lot of surgery support items left from earlier knee and hip ones.

 

[Jamie]

@BusterBeans .... I'm glad you were able to locate a good surgeon for your shoulders. You'll have to give me his name and clinic information so I have it for my lists.

You'll probably want to get a couple of new shirts for your recovery. They need to be about 2-3 sizes larger than you would normally wear so you can put them on more easily. I bought a couple of long-sleeved lightweight flannel men's shirts. When they are that big (mine were XXL), they come down to my knees like a nightgown so I just wore that around the house with some loose pull-on shorts (also a couple of sizes too large). Fashion queen? Uh....no. But it worked great. You will have difficulty getting clothes on and off for at least a month and loose clothing works best.

An battery powered can opener is another must. You won't have much use of your surgery arm for weeks and weeks.

So, is your surgeon planning a hemiarthroplasty on your shoulder? It's also sometimes called a Ream and Run.

 

[BusterBeans]

It will be what’s called here a stemless shoulder arthroplasty. I haven’t been back in for my second visit to ask the specific name of the manufacturer or model or a scheduled date. The surgeon’s office has twice not submitted needed technical documents for my shoulder CT scans so the scans (and my surgeon visits) have been cancelled twice by my insurance. My physical therapist heard a rumor that my surgeon will soon be leaving his current practice to become head of orthopedics at a nearby hospital, so I’ve decided to sit back until after the holidays to see what happens.

I recently had a series of 3 steroid injections and ablation of nerves around 2 cervical discs that were creating great neck pain and headaches. The injections have somewhat decreased my shoulder pain that I can get by with just Tylenol for now. Hopefully I can get something rolling again by April for my right shoulder.

 

[Jamie]

That sounds like a plan.....hopefully your pain will remain under control during this time.

 

[marieltha]

I underscore Jamie’s advice about clothing and inability to use that arm after shoulder surgery. I was very, very sensitive to anything over the incision for a long time. A loose, strapless beach dress, a huge light tank beachcoverup, and huge, light, loose racerback tank tops got me through. I kept light shawls around to drape over my other shoulder for warmth.
I also was very glad I had practiced doing things with my other (non-dominant) hand before the surgery, and had practiced putting clothes on and off the way you have to afterwards.
Jamie’s correct about the can opener, too. My husband opened all cans. The squeezing torque motion was painful well after the period when I wasn’t even using my hand.
So happy with the result, though (rotator repair, not a replacement), so it is worth it. And I’m pretty ambidextrous now!
Good luck!

 

[NoOneSpecial]

After reading so many threads here about shoulder replacement surgery and recovery, I found this article (paid $30 for it too!) and am now convinced more than ever that this method is the only way I will allow a surgeon to do a total shoulder replacement on me. I may have to travel from WA state to Kentucky to get it done, but in my view, worth it.

Thoughts?

PS - says my file size is too large to upload? Is there a way to add an article that is 3.5 mb (it has diagrams of the procedure which is making it a large file).

 

[dapplega]

@NoOneSpecial I'd be curious to see that article. You are in WA and Dr. Matsen at the UW is, by my understanding and research, one the most highly regarded shoulder surgeons in the country. You may consider giving him a visit before flying to Kentucky...

 

[NoOneSpecial]

@NoOneSpecial I'd be curious to see that article. You are in WA and Dr. Matsen at the UW is, by my understanding and research, one the most highly regarded shoulder surgeons in the country. You may consider giving him a visit before flying to Kentucky...

Dr. Matsen at the UW actually did my very first left bankart shoulder repair a long time ago. I'm sorry but I'd never go back - not because of him but because the UW medical system uses med students do the actual surgeries and that is NOT what I'm interested in.

I'll be picking up my right shoulder x-rays today when I go to get my second injection (to get me through the holidays). Then I'll upload them for a consultation with Dr. Greiwe to see if I'm a good candidate for this posterior approach. Then I have to sort through insurance issues before I can commit to getting it. I may consult with Dr. Matsen before making a final decision, but we'll see.

I do know that long-term studies are needed before this approach can be deemed the most appropriate. I also know the only way to get there is for people to be willing to try - and I'm definitely willing to do that.

 

[BusterBeans]

Talk about the stars and moon suddenly aligning...my surgeon’s office, CT scan office and insurance company all called in 1 week to say go ahead. Plus we found out we would be grandparents again after a 20 year hiatus. So surgery will be in March (will learn date this Friday), grandchild will be April 21 & my daughter is coming to visit for the first time in 7 years in April. A lot going on.

The shoulder appliance will be an Arthrex Eclipse. It rather looks like a huge, far screw. My rotator cuff is fine so this is a bone-sparing replacement. My shoulder pain is returning. My surgeon was displeased that another surgeon had performed arthroscopic surgery on both shoulders over the past 2-3 years as I was never a candidate for that. He asked about the knuckle where my right thumb joins the hand and said the arthritis was very advanced. He had his therapists build a removable cast for my hand which has really helped with that pain. The hospital is only an hour away and the traffic and drive aren’t bad. Only 1 overnight. My only concern is the surgeon said it would be a regional plus general anesthesia. I’ve had such problems with general anesthesia that I drew this. He said he’ll help set it up so I meet with anesthesia prior to admission, but I would rather meet with the anesthesiologist I will have prior to the day of surgery since I’ll need a propofol TIVA and no midazolam. Hopefully there’ll be no repeat with the sux.

My family doctor did put me on blood pressure meds 2 weeks ago. She had been monitoring it for a year and finally said enough. My diet meditation & exercise changes didn’t drop it so she needed to do something.

 

[Jamie]

How exciting about a new baby in your life. And it's great that the surgery is coming together for you too. Great!!

 

[BusterBeans]

I reported to the hospital early Tuesday for a 7:00 prep for a 9:00 surgery, then waited and waited. No one would tell me anything. Finally someone from hospital registration said my surgeon’s office hadn’t obtained authorization for the surgery from my insurance company and was trying to do so. The week before I had wondered why I hadn’t received an authorization letter and called my insurance company. They said my surgeon’s office had just started working on it and would hopefully finish it in time.

As the morning went on, my hopes for surgery diminished. Around 10:00 hospital registration said my surgeon’s office was trying to push authorization through but that the clinical nurse at my insurance company wasn’t returning their calls. At 11 hospital registration said my surgery was cancelled and my surgeon’s office would be in touch to reschedule it. Our hotel reservation was non-refundable so we just went home.

That was 2 days ago and I still haven’t heard from my surgeon’s office. Not even an apology or explanation. But yesterday I scheduled an appointment with a shoulder specialist with the Mayo Clinic. It’s a 2-1/2 hour drive but I’m ready for a 1st class, professional medical organization. But I must say what a bummer after I had cooked and frozen 3 weeks of meals and had myself so mentally prepared.

 

[Jamie]

Boy, what a horrible experience! I believe I would be talking with that surgeon's office about a reimbursement for your expenses because of their negligence. There is absolutely no excuse for what they did to you. Good for you for taking your business elsewhere!

 

[tazzy13]

wow what a disappointment, hopefully the Mayo Clinic can get you in and surgery scheduled quick so the food you prepared will still be good. Wishing you the best.