Shoulder Joint Replacement

I found out today that I am a candidate for partial or total joint replacement in both Shoulders. DJD, degenerative joint disease, or let just call it good old fashion Arthur Ritus. It all depends on what the MRI shows this Friday. If my rotator cuff surgeries, (3), over the past few years have healed well, then it will be total joint replacement. If the previous RC surgeries are not good then it’s time for the partial joint replacement.

The new doc is a specialist in shoulders. Water skiing, four wheelers, & snow machines are out. No problem so far, cause I don’t do any of those things. No rototillers. Now that’s a problem. I have a huge vegetable garden. I still won’t be able to pull myself up in a saddle on a horse. That still sucks. I will be able to paddle a kayak. Hall la loo ya. I have to be able to paddle. I can become a total carnivore and quit eating vegies. Let the horses get fat and sassy, but I must be able to paddle.

Question is, do have the surgeries to replace the joints, or do I live with the pain? I do 2 vicodins when I paddle now, and they don’t really knock the pain all the way down. Hate doing the drugs, but it just hurts too much to paddle without it. I’m sick of the pain. It wakes me up a few time every night.

I sure hope there’s someone out there that will tell me, “yes, go ahead with the joint replacement you’ll be able to paddle just fine in 6 months with lots of physical therapy work”.

I sea kayak on Lake Superior, and larger inland lakes in Northern Wisconsin.

Seems like you might have to learn
to take pleasure from paddling smaller inland lakes, and sheltered bays on Lake Superior. Hope it turns out better than that, but be prepared.



If you were a concert pianist, I might suggest getting a clavichord and playing it in a small, resonant room.

Keep us posted
I have no advice for you. I didn’t even know shoulder joints could be replaced! I thought the muscles of the RC held the shoulder together and it was not a joint such as in a hip or knee.



But my shoulders have been squeaking more and more over the last year, so if you keep us posted I will be following your progress.



Good luck with whichever option you choose.



~~Chip

When you had the rotator cuff surgery
did the surgeon tell you your shoulder would be as good as new after pt. I had a complete tear in my shoulder. Had the surgery and it has never been pain free. I had a couple follow ups with the surgeon and he says everything looks good. Please let us know what you decide as I would like to know the outcome.

I, too want to know how it turns out
I’m really sorry you are having problems - Many of us, including myself are having trouble too. So keep us informed on your progress.



Good Luck,

LF

Try rowing
My problem could be totally different than yours. I have shoulder problems that I am working on. I just started getting into canoeing a couple of years ago. The problem is that every time I canoe or kayak I get very bad headaches.My massage therepist said canoeing and kayaking are not good on the shoulders. Last summer I bought a sportspal canoe and started rowing it with the oar locks, the headaches stopped. My story may not help you but you never know. Good luck.

No one can tell you what to do.
I do have two bits of information, which may or may not be useful to you. They are both hearsay, so probably not. I’ll pass along and you decide.



First, a neighbor of ours who is in his 70’s had a complete shoulder replace three or four years ago. He is extremely consistent with exercising. His report is that he has a better range of motion and far less pain than he had before the surgery.



Second, the physical therapist I was seeing after my shoulder decompression said that I should avoid replacement as long as possible because full range of motion is no longer an option once you get it. Of course, if you don’t HAVE full range of motion, then it would just be a comparative value.



Good luck with your decision. The best thing is to get the advice of a specialist (which you have) and talk to people who have been through a similar surgery.


  • Big D

Seek other professional advice
Obviously, you are not convinced by your surgeon. I know that I would get some cross opinions form other partitioners who are not surgeons like pain management specialists, chiropractors, message therapists and more. Some people have good luck with surgery and there are cases of those who would never do it again or recommend it to anyone else. I always consider surgery the last resort.

With major surgery
four things can happen, three of them are bad (no improvement, situation worse, R.I.P.), and all are expensive. Keep that in mind.



I had rotator cuff surgery several years ago. It was done by a local guy, the junior man in his orthopedic practice. I only got worse. My regular physician said, “We have to get you out of town to see someone who spends all day ‘doing shoulders’. ” He got me a referral to the hospital at Duke University, where I saw the top shoulder guy in the region.



Turns out my problem wasn’t rotator cuff at all. It was a combination of osteo-arthritis, broken down cartilage and loose bone chips (etc.) from a very old injury that I had been living with. This doctor spent 5 or 6 hours extracting all sorts of “crap” (his word) that was floating around in my shoulder and causing much of the pain. He recommended I take up a paddling sport, which has brought me back to canoeing after a lapse of many years. He did not recommend joint replacement in my case. I’m happy with the results. My shoulder is about 80 percent and the pain, with the passing months, continues to diminish.

Sounds like too much pain
If I had to take painkillers just to paddle, I’d go for the surgery. The real question might be “total or partial?” But at the very least, see what your shoulder specialist says after he gets the MRI results back.



My shoulder doc took a conservative approach with my shoulder problems. I spent most of this year doing home exercises (after the PT was over), and they did indeed help restore mobility and strength. But not enough. My doctor then said it was up to me whether to do the surgery or not, depending if I “could live with it the way it was.” After the improvement stopped, I waited another couple of months, then decided to schedule surgery. Mobility was almost as good as it was pre-injury, but strength was not, and the critical thing was the funny “catch” I still occasionally felt in that shoulder. The PT and exercises just did not get rid of the impingement, and the surgery (decompression) did. I am now back in PT and still doing home exercises. The catch is gone, and I look forward to resuming all activities gung ho next year! I’ve already started planning for a month of kayaking lessons in the PNW, something I could not commit to last year.



BTW, my MRI which was taken early in the summer did not show any bursitis but the surgeon said there was some in there after all. So use your own body’s sense that “something is wrong” as the ultimate decision-maker.

Shoulder Surgery…
So you are already taking Vicodin to help with the pain. I’m assuming anti inflamatory meds aren’t helping much? (advil,aleve, rx drugs) Review the MRI with your doc. I’m assuming the plain xrays aren’t conclusive? And I’m assuming your rotator cuff is ok. 4 types of “replacements”. Partial: the “ball” of the ball and socket is replaced and the socket is left alone. This is like a half replacement utilizing the method of a metal stem being fitted inside your humerus bone (cemented or noncemented with the latter being used the most depending on bone quality) and then a metal ball being placed onto the stem to fit your socket. #2 Resurfacing: The ball of the humerus is exposed, then reamed down to fit a metal implant that fits your socket,but is implanted on your humerus, and is not cemented in. Socket is left alone other than cleaning it up. #3 Full total joint replacement where the above noted (#1)stem is used and the socket is reamed out and a polyethylene liner is cemented in to “replace” the socket. #4 Reverse total shoulder replacement. Meant for folks who have bad rotator cuff injuries that never healed well. Reverse meaning the metal ball goes where the socket is supposed to be and the socket goes where the ball used to be. Find a shoulder surgeon. Someone who does this all the time or at least 3/4 of the time. Physical therapy is crucial. Of course with any surgery, there are no guarantees. But if your are needing narcotics to knock down the pain. You just might need a replacement. I guess the best thing to tell you is you can always get a second oppinion from a “shoulder specialist”. It’s your body. Your primary ortho doc shouldn’t mind…

2nd Opinion
I started the process of getting a second opinion about needing joint replacement of my shoulders. I’m going to the Mayo Clinic. You can’t get much better than that.

Sounds like a lot of you guys have differing degrees of should problems. I’ll try to keep you all abreast as to what will happen.

I still wish there was someone on this board that had shoulder joint replacement. I sure would love to talk to them.

Thanks for your reply Tebpac!
You really know your stuff about shoulder surgery! I’ve been reading about the things you mentioned all day today. May I ask how or why you are so well informed? Are you a doctor?

If someone could tell me I will be able to paddle my kayak after the surgeries I wouldn’t hesitate for a minute to have it done. I know it will be a lot of hard work with p. t. , and I’m ready for that. I would just be sick if I couldn’t paddle any more.

Your Welcome…
I’m an orthopedic physician assistant. One of our guys does a lot with shoulders so I see alot of total/partials done. I spoke with our “shoulder guy” and he said paddling shouldn’t be a problem but PT plays an important role of course. Hope this helps.



Todd

Thanks again Tebpac!
I’m taking your advice and getting another opinion. I’m going to Mayo Clinic. Can’t get any better than that. It’s about 300 miles away, but after 3 rotator cuff surgeries, and 8 years of pain it’s time to go see the Big Dogs.

Shoulder Options.
Very wise to get the opinions of Mayo doc. They know their stuff! My wife is a therapist (OT) who has treated many total shoulder replacements in a geriatric setting. She says they are almost all quite successful. She has only had 1 or 2 PT’s that have done poorly, some have happily had them both replaced. She says bone on bone is the most common need for the proceedure. Rehab is everything!



If you got to have it done I would feel pretty positive about returning to a life of paddling although you may have to make some concessions.



Nonetheless, all surgeries are a bit of a gamble. I am at home recovering from knee surgery at this time. Had the same proceedure done 3 times and recovery was different for each.



Keep us posted & good luck.



Tom

Yes, please keep us informed…
I will be interested in what you find out and what you decide to do.

My doctor thinks that I should wait as long as possible for joint replacement because they are getting better and better at it all the time.

I get cortisone shots in my shoulders when it gets too painful for me to manage with medication that doesn’t make me dipsy.

I realize that this speeds the deterioration of the joint but they’re deteriorating anyway and in the meantime I’m able to keep paddling.

I haven’t been surf kayaking for over a year now though. :frowning:

absolutely…
Let us know what you find out…



Todd

I will.
Had the MRI yesterday. Faxing X ray report, MRI report, and Doctor’s notes to Mayo next week. Probably won’t hear anything for a few weeks however. I’ll keep you all posted that are interested. Take care of those shoulders out there! If I do the replacement I think I’ll have it done during the end of August after the majority of the paddling season is done, and before school starts, (I’m a teacher)

Paul

shoulder replacement
I am not a medical professional but I had a total shoulder replacement two weeks ago. I was in such pain it was difficult to shower, dress, or most anything. Within two days after the surgery I was in no pain at all. I was given the OK to drive locally on day 10. Am supposed to wear the sling but can’t figure it out. I’m having the other shoulder done in March. I too am looking forward to kayaking again. BTW, I’m almost 70. Just wanted to say that for me the decision to have the surgery was one of the best decisions I’ve ever made.