Shoulder Replacement

[B Lafferty]

I have an old injury to my left (shooting) shoulder. The shoulder has been loose for years. If I reach up and back as in basketball, it will pop our of joint. It's always gone right back in (painfully for a brief time).

Whilst shooting air pistol it had not been too painful. An Advil a half hour before shooting is all that's needed. However, of late the stability of the shoulder when ready to release a shot has gotten worse. In a 60 shot match or practice I can count on the shoulder joint popping slightly. If this happens at shot release, it results in a flier that is generally to the left, hitting between the two and four rings.

There's not much short of surgery to tighten up the joint or replace it depending on how deteriorated the joint is.

I'd appreciate hearing from anyone who has had an actual shoulder replacement.How did it work out? Back in the early 2000's when I was actively racing bicycles, a friend needed a hip replacement to continue any kind of cycling. The main choices then for hips were titanium or ceramic. He opted for ceramic and was thrilled with the result. Of course, with shooting, there is much less movement. Stability and range of motion are the issues.

Thanks in advance for any info folks may have.

[ShootingSight]

I had shoulder surgery for a torn rotator cuff, not replacement.

Worst thing was the constipation. I sh*t you not (no pun intended). After they slice into your body, the small sticker on the pain meds that says 'may cause constipation' is way easy to overlook, but that was more unpleasant than the pain. Pain meds enter your body via your intestine, so the first muscles they knock out are the muscles around the gut that pump stuff through you. It was so bad you stop eating for a day and a half because you are literally 'full'.

Anyhow, highly recommend you start taking stool softeners before you go in, and have laxitives at home ready to go. I've talked this with lots of people who had joint surgery, and strangely enough, everyone had the same experience, but most people just don't talk about it.

[bking]

I had surgery for instability of my left shoulder two months ago. I had torn labrum and a bony Bankart lesion (fracture of scapula.) When moving my shoulder in certain ways it would dislocate and I had pain when extending the arm as if to shoot (though I shoot with my arm pretty flat to my shoulders, way out to the side.)

Two months after surgery I’m already more capable than before surgery, but it’ll be a year before I expect to have relatively full range of motion. I could probably shoot 10 or 20 shots with my left arm now but no way a full match. Post-op was quite painful and I spent a month with my arm in a crazy sling all the time. Most of the first couple of weeks I was attached to an icing machine. I avoided narcotic pain killers to avoid side effects & dopiness.

Apparently recovery from a full joint replacement is much easier and quicker than a repair like I had. Good luck!

[B Lafferty]

Thank you for both replies, I caca you not.

I'll have it evaluated after the first of the year. My aunt/godmother had two knees replaced, one per year, and the recovery was relatively easy. I suspect my shoulder is not in significant enough arthritic condition to mandate replacement.

I had a stable fracture to my pelvis resulting from a bicycle racing crash in the mid-90's. I do recall the dreaded slowed intestinal track issue. I pretty much avoided it by sticking to a mostly liquid diet for a week. Then I was off the stool slowing pain killers. I don't remember much of that week......

[joel]

The orthopedic surgeon I consulted with said that shoulder replacement surgery only gives about 75% range of motion after all is said and done. It is not nearly as common as other (e.g. hip) joint replacements. This is why I am very cautiously considering it.

Joel

[-TT-]

Ask the surgeon about getting a nerve block. I'm recovering currently from rotator cuff repair (shooting lefty for now with decent success btw), and have experienced very little pain, with nothing but ibuprofen and occasional acetaminophen.

For the nerve block, they inject a long-lasting lidocaine all around a key nerve. It immobilizes the arm for about a day, and numbs the shoulder for several more. This takes you past the hard part and really helps recovery. I got an rx for Vicodin and tossed it unused.

Yes, the shoulder is a complex and wonderful joint. You're well-justified in going in with great caution. If repair is an option, give it extra consideration.

[ML1944]

It has been about 8 years now. I had a total right shoulder replacement. I heard so many horror stories about shoulder surgery, I postponed it until I couldn’t move my arm and the pain was constant and unbearable. I almost let it go too far. The Doc. explained that the longer you wait, the potential for permanent loss of function increases. At that point he would only promise me elimination of the pain. I was out of options so I went for it.

I would suggest:
Get referrals from others in healthcare. I was able to talk to Doctors, Nurses, and even a sales rep that sold joint replacement materials. They have the inside information on who is the best. Ask how many procedures he has done. I found a guy that specializes in shoulders, elbows and wrists only.
Speak in detail with your Doctor regarding your procedure. Have him explain what he is going to do and why he is taking that approach. There are usually different ways to achieve the same results depending on circumstances. Don’t accept being talked down to. The best doctors will have no problem taking the time to explain things in terms you can understand. It is to their advantage that you have realistic expectations and have no unexpected results.
Rehabilitation. Expect about six months of rehab. for a shoulder reconstruction. Maybe less for a shoulder repair. It will vary. I was out in three, but that was unusual. The end result of surgery is hugely dependent on the quality of your rehab and how well you follow it. The best surgical result will be wasted if you don’t get the proper rehab and / or you don’t follow it. Your recovery is a team effort with you as a major part of the team.
Pain management. Can’t stress this enough. Have a pain management plan in place before you have your surgery. No way around it. This is going to hurt! A lot! The surgery is traumatic. The rehab will aggravate the surgery. You want to have an effective plan A and plan B, etc, etc. Your rehab and ultimate effective recovery will depend on it. Don’t let them tell you Tylenol will be enough. When I had my surgery, opioids were accepted as the standard pain management method. Today, not so much. Problem for me was I couldn't tolerate the standard pain meds. We finally settled on low dosage morphine. No nausea! Didn’t get high! Strangely, I felt every bit of the pain, but I just didn’t care!!! Due to its addictive properties, I don’t think morphine would be considered today. I was closely monitored to avoid any issues and I didn’t have any. I don’t know the new pain protocols, nor how effective they are. Talk with your Doc. Pain and your ability to tolerate it will affect your recovery. It is a balance and varies
with everyone. Don't be a hero. You won't impress anyone that knows and it can hurt you in the long run.
I’ve gone on too long. I don’t want to scare you. Shoulder repair / reconstruction is not easy, but can be absolutely rewarding. Three months after surgery they kicked me out of rehab. I had regained about 85% of function with some minor discomfort effectively controlled with ibuprofen. After six months, I was totally pain free, at about 95% function and I could shoot without discomfort. Not shooting any better but without pain. My only restriction is nothing with heavy recoil. Doc says he would be p***ed if I screwed up his work!
Best of luck,
Mike