Reverse Shoulder Replacement Will A Reverse Shoulder Replacement Force Me To Change How I Live?

[Nukeofearl]

Hello

I had a TSR on 6/10/2019 due to severe arthritis. My doctor specializes in shoulder replacements and rotator cuff repairs. It is all he does. He is very highly recommended by multiple other doctors I know.

The first eight weeks after surgery were good. PT was going really well. I showed almost daily improvement. It was amazing.

Then something happened and within a week I had lost everything I had gained in PT. The doctor stopped PT and gave me a steroid shot directly into the shoulder. He restarted the PT. I had a pain free weekend then went to PT on Monday. PT was very gentle yet that evening, the pain returned like I never had the shot.

PT was stopped and the doctor had me rest the shoulder for two weeks, thinking it would improve. I took it really easy for those two weeks. It did not, in fact it continued to get worse. I have been in constant pain since.

The doctor did an ultrasound of rotator cuff tendons and they were not conclusive for showing any tears. He also did new x-rays and they showed the new shoulder hardware was all in the right places.

He feels that since I am presenting all the symptoms of a rotator cuff tear, he recommends doing a revision and changing the shoulder to a reverse shoulder replacement. The surgery is scheduled for October 21, 2019.

I am an active 65 year old. I don't play sports but do ride my recumbent tricycle as much as I can. My primary hobbies are wood working, home improvements, and maintaining my motorhome. I have read that the reverse shoulder can dislocate easily and you have to treat it "gently."

Will this new shoulder cause me to change the way I live? If so how?

Thanks!

 

[Jamie]

I'm sorry it looks like you're going to need your shoulder revised. It is my understanding that a reverse shoulder replacement works very well, but because of the way the components are placed, you don't have quite the range of motion as with a regular replacement. Assuming this will be the case for you, it would only impact activities where you needed to raise your arm high above your head or reach behind your back. Since your surgeon knows your particular case, he'll be better able to explain what may be your limitations.

If your home and motorhome projects involve working above your head, this could be more difficult for you. You also should watch lifting heavy items above chest height. But this is good advice for most people.

There is some risk of dislocation or subluxation following a shoulder replacement, but this lessens as you complete therapy and strengthen your muscles that will keep your joint in place. Generally the guidance is to watch sports such as tennis and racquetball, but it doesn't sound like it's going to be an issue for you. Just go slow adding back in your normal activities and follow the guidance your surgeon gives you.

 

[Nukeofearl]

Many thanks! With the arthritis I have in both shoulders, I've long ago learned to minimize the overhead lifting in whatever I am doing.

Does the reverse shoulder have specific weight limits for above chest and below the chest lifts? If so what are they?

You mentioned lesser range of motion. Are most people who have this procedure still able to thread their belt through all the loops on a pair pants? If I can still do that and tuck my shirts in, I will be happy.

I did not know what questions to ask the surgeon until researching this on the internet. The surgeon
has not discussed limitations with me so far.

He has told me that this procedure is significantly easier to come back from and usually the recovery time is much less than a normal TSR. Have you found this to be case? In general, can you give any any idea of how much faster the recovery time usually is?

Again, thanks for your time!

Very Respectfully,

Mike

 

[Jamie]

Does the reverse shoulder have specific weight limits for above chest and below the chest lifts? If so what are they?

I've not ever seen any specific weight limits for lifting after a reverse shoulder replacement, but it is advised that you don't routinely lift above 50 pounds. This is a case where you need to let your body guide you. You wouldn't want to lift anything that heavy for the first 6 months. And you shouldn't suddenly lift such heavy weights. But if you work on strength training with your therapist, you may be able to work up to that weight level as long as it's not a constant activity.

You are going to have a lot of limits to your activity immediately after surgery and possibly up to that 6 month time frame. Your surgeon will guide you in that, as he knows your specific situation.

He has told me that this procedure is significantly easier to come back from and usually the recovery time is much less than a normal TSR. Have you found this to be case?

The reverse shoulder procedure is a bit easier to recovery from than a standard replacement because the surgical procedure itself is different. It may be from a few weeks to a month shorter. But, remember, every person's recovery is unique and there are no hard and fast rules. I suggest you not make any big plans to be recovered and back to normal activity for at least for the first 6 months. You'll be doing things fairly normally at the 3 month stage, but your body will still be recovering and learning how to use muscles differently with the reverse joint. It will be important not to try and push yourself. You can do real damage if you do push.