This is the story of an 82-year-old, active woman with severe shoulder arthritis who, along with her doctor, decided on a reverse shoulder replacement to treat her arthritic pain.
The patient is a very active, 82-year-old woman who lives at home alone. Fifteen years ago, she underwent a shoulder replacement in her right shoulder to treat her shoulder arthritis. She has developed pain and progressive loss of function in her left shoulder over the past 18 months, due to arthritis. She’s experiencing significant pain at night which wakes her from sleep several times each evening. She has also had to cut back on activities that she previously enjoyed such as playing in her woman’s golf league and gardening. She has even noted that playing cards with her friends is painful.
Due to the pain, she initially saw her primary care doctor who recommended an injection. This helped for a short time, but the pain recurred in her shoulder. Her primary care doctor noted that it was likely due to shoulder arthritis. Her doctor referred her to an orthopedic surgeon; however, she remembered how hard it was for her to recover from her prior shoulder replacement surgery. She remembered the significant pain that she experienced, the big bulky sling, and the very long recovery.
Additionally, she remembered having to make several trips every week to a physical therapist. She didn’t want to be a burden to her children with the need for them to take her to the therapist every week for up to 12 weeks.
After a year of trying to tough it out, her pain became increasingly worse, and her function continued to deteriorate. She had to decrease the activities that she once enjoyed, as well as significantly missing the social interaction she had as a part of her golf league. Therefore, she decided to see an orthopedic surgeon.
The patient made an appointment to see an orthopedic surgeon that was recommended by her primary care doctor. She had a CT scan and X-rays which showed severe shoulder arthritis with a large amount of wear of the glenoid socket.
Radiographs of the shoulder demonstrating severe arthritis:
CT scan demonstrating a significant amount of glenoid wear:
After evaluation, the patient was notified that she was a candidate for a reverse shoulder replacement. What was most surprising to her was how significantly things have changed since she had her replacement in the opposite shoulder 15 years ago.
Not all patients are candidates for this product and/or procedure. Only a medical professional can determine the treatment appropriate for your specific condition.
The patient’s orthopedic surgeon described to her the significant advances in anesthesia that have occurred since she first had her replacement including the use of multi-modal anesthesia. Multi-modal anesthesia simply means that a variety of different agents are used to manage the pain in an effort to minimize some of the unpleasant side effects of narcotic pain medication. She was happy to hear about these advances since one of her main concerns was pain after the shoulder replacement surgery. Fifteen years ago, she spent three nights in the hospital after surgery. Now the surgery could be performed with one night in the hospital.
In addition, her surgeon noted that rather than having her arm in a sling for 12 weeks, it’d only be about 6 weeks now. Her orthopedic surgeon also noted that all the sutures used in her skin would be absorbable and wouldn’t need to be removed. Rather than waiting a week to shower, she could shower two or three days after surgery.
The patient was also thrilled to hear that she could do all the therapy on her own at home and not have to drive several times a week to a physical therapist. This was very important to her not to be a burden to her family.
The patient decided to proceed with the shoulder replacement surgery. Her surgeon performed a reverse shoulder replacement which addressed both the rotator cuff insufficiency as well as the arthritis.
Talk to your surgeon about whether joint replacement is right for you and the risks of the procedure, including the risks of infection, implant wear, loosening, breakage or failure, any of which can necessitate additional surgery or treatment. You can read more about the risks of shoulder replacement by clicking here.
Example of a reverse shoulder replacement:
The patient spent one night in the hospital. The next day, the therapist taught her the physical therapy exercises to do on her own. She also learned how to place the sling on top of her clothes.
The patient returned home the day after her shoulder replacement surgery. She was able to do the physical therapy on her own at home and was off the narcotic pain medicine within five days of the surgical procedure. She discontinued the sling at six weeks. At eight weeks, she was back on the golf course with her friends working on her putting and at 10 weeks she was chipping the golf ball. She was able to sleep at night without pain and the procedure allowed her to return to her active lifestyle.
Shoulder surgery is a major endeavor. Recovery and results are dependent on patient compliance with post-operative instructions, including physical therapy exercises and activity restrictions prescribed by your surgeon.
Appropriate post-operative activities and pain will differ from patient to patient. Results are not necessarily typical, indicative, or representative of all recipient patients. Results will vary due to health, weight, activity and other variables.