Reverse shoulder operation

I don't think my surgeon shared with me how much they were retracted. If he did, I don't remember. I do recall talking about the possibility of being unable to pull them into place and he would only know once he got in there.

I don't recall the names of the various parts in there, it is written down somewhere. I have a record of which ones were torn off. One was actually attached to the bicep, and it was torn off at least 20 years ago, but he fixed it. Amazing! I was able to function normally for years with bicep damage.

It was after surgery that he informed me it was a total success. Mine was the first time I had this done, and I have been extremely physically active all my life, especially with my heavy lifting and such in my work. Perhaps that played a role, I don't know.

No extra material was added to mine.

I was supposed to have a follow up visit several months ago, but with covid, that never happened. Last follow up was a phone call. If I talk to him again, I will try to remember to ask. I am still not cleared to go back to work, but I am anyways. I gotta eat too...

Bob do you remember how much the ligaments were retracted? The Super Spinaus(one at the top) was retracted 2.5 ins. It was already repaired one in 2003 with 4 molly bolts. Did the have to use a spacer from a cadaver to reattach it?

Interesting analysis of the contracted ligaments.
My injury was several years old when they did the surgery and they had been contracted a long time. They managed to re-attach them all. I was lucky I suppose.

I guess we are all different, and our surgeons are too.

Mine is improving every week and I am now trying to force more movement. I didn't do it at first even though they told me to. I was fearful of tearing the shoulder apart again.

It is so nice to have the pain almost all gone, just the occasional twang if I do something. I can live with the limited mobility, but I may get it all back.

BobsYourUncle wrote:
Best of luck to you, and yes, let's pray it can be fixed with minimal effort.
Do keep us posted.

I saw the MRI and got the Dr's report this week. Two of the rotator ligament's are torn completely. The top one is contracted 2.5 ins so it cannot be stretched back and reattached. Apparently two were old tears more than a year old probably several years old. I did not realize it at the time but each time I used my arm more damage was being done. Bicep mussel is torn and out of position. He said I had a strong deltoid mussel so I can still lift my arm. He recommended still going back to the gym otherwise mussel atrophy would get worse. Just no lifting overhead and no adduction or abduction exercises then wait until the pain gets worse and get the reverse shoulder. Hopefully it gets better. Moral of the story is if you ever have diverticulitis and take Cipro to heal the infection it softens your ligaments, be carful what you lift.

I have no personal experience but my Bro who slightly older had the opration about a year ago. He is back at work as a contract management inspector for almost 7 months. Sore after splitting firwood, not pain, only about90% range of motion. The stupid s@#t is 80 and went back to work. Should have taken the retirement that was recommended.

Best of luck to you, and yes, let's pray it can be fixed with minimal effort.
Do keep us posted.

BobsYourUncle wrote:

Gjac wrote:
Glad you are on the mend Bob. Do you know what he actually did to make the repair? I did not realize I torn mine completely off over a year ago that is why they shrunk. Apparently other muscles get stronger and compensate somewhat so I was still able to do pullups and any kind of pulling exercises. I just could not push anything over head or any other pushing exercises. Then about a month age I fell off my bike in soft sand and that tore the bicep tendon and pulled it out of joint when I put my arm down to break the fall. I have an appointment next wed to review options. The reverse shoulder seems very extreme that is why I asked here hoping there may be another option.

Thanks, yes I am on the mend for sure. I likely could have been further along, but I got lazy with my at home physio and exercise. I was actually very paranoid about re-tearing the muscles off again, so I was extremely careful not to overdo it.

Doctor told me that he used something to basically "rivet" them back onto the bone. Not an actual rivet, but something similar in concept. He told me that with the attachment to the bone, it would bond itself naturally over time, which it has done.
I was in a sling for 6 weeks with no use whatsoever of my shoulder. I could use my hand a bit at my side but no more.

It sounds like your injury is similar to mine, so perhaps the extreme "reverse shoulder" procedure may not be needed. Obviously, I am not a doctor and I am only guessing at that. We are all different. But it sounds like yours was done in a similar fashion. If it is just a case of muscles/tendons being torn off the bone, then the arthroscopic procedure used on me may suit you. Arthroscopic is a small incision where they insert the tools to perform the repair, rather than cutting things wide open. It heals faster too. I have 3 small scars where he went in.

My other muscles did indeed compensate, and I was still able to do a lot prior to surgery. I couldn't lift my arm over my head, but I could grab it with my left and drag it up there. Once above my head I could put a drill in my hand and use it, albeit with a lot of pain. Strange thing...

I was still working out at the gym after the injury. I refused to accept I was hurt I guess. I was ok pushing / pulling down low, as long as I didn't try extending my arm. With the injury I could still dead lift 245 with a straight bar, 265 with a trap bar. Not bad considering I was 65 when I had things fixed.

My muscles were badly atrophied before surgery, as they were torn right off and resting in the contracted position. But the doc was still able to stretch them out enough to reattach to the bone. I was nearly 4 years from the injury date to surgery, so they had lots of time to just sit there doing nothing.

I agree with the things Kevin is saying here too, sounds like he is educated in this problem too.

You are only a few years older than I am, you said you are active, so am I. I would try for the reattachment process before getting radical about it.

Recovery? Well, I have to admit, after surgery I had a dickens of a time. There was no comfort to be found in bed. As soon as I laid down, the aching set in. And it was miserable. Lots of pillows, sleep upright, try a recliner chair, I did it all. I took the meds they gave me once, only once. Opioids, and they put me into a stoned stupor. I did use Advil for the first couple weeks, then decided to tough it out. Drug free body, and I like it that way. Yes I suffered a lot at first. However, after a couple months passed I was able to sleep again with less discomfort. It's a process, you gotta go through some ugly times for the first while. But it does pass.

I am now pain free. My shoulder no longer sounds like a bowl of rice crispies when I move it. I am now glad I had it done, wasn't sure at first. The lack of living in pain makes it all worthwhile. I imagine I will be another while before I'm back to normal. I could exercise more..

Yes Bob it seems like a similar injury. The only think different is my Dr said two of the tendon shrunk and could not be pulled back to the original position without the use of a cadaver skin to use as a filler material. The rivets you talked about were probably Ti moly bolts I already have 4 in each shoulder. The original surgeon said he would try to do it arthroscopically but I ended up with 4 in long scars. I guess the MRI helps but they can't really see how bad the damage is until they open you up. I have just been praying that the tendons can be repaired without going to this radical surgery.

Gjac wrote:
Glad you are on the mend Bob. Do you know what he actually did to make the repair? I did not realize I torn mine completely off over a year ago that is why they shrunk. Apparently other muscles get stronger and compensate somewhat so I was still able to do pullups and any kind of pulling exercises. I just could not push anything over head or any other pushing exercises. Then about a month age I fell off my bike in soft sand and that tore the bicep tendon and pulled it out of joint when I put my arm down to break the fall. I have an appointment next wed to review options. The reverse shoulder seems very extreme that is why I asked here hoping there may be another option.

Thanks, yes I am on the mend for sure. I likely could have been further along, but I got lazy with my at home physio and exercise. I was actually very paranoid about re-tearing the muscles off again, so I was extremely careful not to overdo it.

Doctor told me that he used something to basically "rivet" them back onto the bone. Not an actual rivet, but something similar in concept. He told me that with the attachment to the bone, it would bond itself naturally over time, which it has done.
I was in a sling for 6 weeks with no use whatsoever of my shoulder. I could use my hand a bit at my side but no more.

It sounds like your injury is similar to mine, so perhaps the extreme "reverse shoulder" procedure may not be needed. Obviously, I am not a doctor and I am only guessing at that. We are all different. But it sounds like yours was done in a similar fashion. If it is just a case of muscles/tendons being torn off the bone, then the arthroscopic procedure used on me may suit you. Arthroscopic is a small incision where they insert the tools to perform the repair, rather than cutting things wide open. It heals faster too. I have 3 small scars where he went in.

My other muscles did indeed compensate, and I was still able to do a lot prior to surgery. I couldn't lift my arm over my head, but I could grab it with my left and drag it up there. Once above my head I could put a drill in my hand and use it, albeit with a lot of pain. Strange thing...

I was still working out at the gym after the injury. I refused to accept I was hurt I guess. I was ok pushing / pulling down low, as long as I didn't try extending my arm. With the injury I could still dead lift 245 with a straight bar, 265 with a trap bar. Not bad considering I was 65 when I had things fixed.

My muscles were badly atrophied before surgery, as they were torn right off and resting in the contracted position. But the doc was still able to stretch them out enough to reattach to the bone. I was nearly 4 years from the injury date to surgery, so they had lots of time to just sit there doing nothing.

I agree with the things Kevin is saying here too, sounds like he is educated in this problem too.

You are only a few years older than I am, you said you are active, so am I. I would try for the reattachment process before getting radical about it.

Recovery? Well, I have to admit, after surgery I had a dickens of a time. There was no comfort to be found in bed. As soon as I laid down, the aching set in. And it was miserable. Lots of pillows, sleep upright, try a recliner chair, I did it all. I took the meds they gave me once, only once. Opioids, and they put me into a stoned stupor. I did use Advil for the first couple weeks, then decided to tough it out. Drug free body, and I like it that way. Yes I suffered a lot at first. However, after a couple months passed I was able to sleep again with less discomfort. It's a process, you gotta go through some ugly times for the first while. But it does pass.

I am now pain free. My shoulder no longer sounds like a bowl of rice crispies when I move it. I am now glad I had it done, wasn't sure at first. The lack of living in pain makes it all worthwhile. I imagine I will be another while before I'm back to normal. I could exercise more..

NRALIFR wrote:
Gary, I understand how you feel about the reverse shoulder surgery. It sounds extreme to me as well, which is why I haven’t gone that route yet. My doc also feels I should hold off as long as possible, because there’s the possibility that if it’s done too soon you could actually wear out the new parts and need a second replacement 15 or so years down the road.

There are four rotator cuff muscles, and it’s not uncommon at all for someone (males especially) to tear or totally separate the two smallest ones by the time you’re in your mid-forties. That’s what I did in both shoulders, and just thought it was normal “getting old” aches and pains. Then moving some heavy equipment I started tearing my right deltoid away from its attachment point at the shoulder. That didn’t hurt too much until the muscle started ripping down the middle, and I lost use of my upper arm.

During surgery to fix the tear, the doc also found that the bicep long-head tendon was damaged to the point where it had to be cut loose and not reattached (bicep tenotomy vs. tenodesis where it’s reattached to the upper arm bone), so my right bicep looks funny now. My upper arm was immobile long enough that all the arm and shoulder muscles associated with it atrophied. Getting them working again took several months, and the 24x7 pain didn’t stop for almost two years.

Today like I said, I have 90-95% range of motion, maybe only about half of the upper arm and shoulder strength, and similarly diminished endurance with that arm. Working above shoulder height is difficult, but I can do it if it’s for a short duration. It’s not pain free, but it’s manageable without Rx drugs, and thank goodness it’s no longer 24x7.

So, you CAN live without some of your rotator cuff muscles, half your bicep disconnected, and a repaired deltoid. But I would never advise anyone which way to go on this. The wisest thing to do would probably be to get a second and maybe even a third opinion. Your age will likely play a big part in what you decide.

:):)

Thanks for sharing your experience Kevin. I am 73 but fairly active. I can live with the pain I have had knee arthritis since 52 and was very painful at first, and now no longer notice it except from getting off of a chair. I guess you get used to the pain. What I worry about is further tearing out my bicep mussel or doing some other damage. I know what you mean about rehab it took me 1&1/2 years to rehab each rotator cuff repair.

Gary, I understand how you feel about the reverse shoulder surgery. It sounds extreme to me as well, which is why I haven’t gone that route yet. My doc also feels I should hold off as long as possible, because there’s the possibility that if it’s done too soon you could actually wear out the new parts and need a second replacement 15 or so years down the road.

There are four rotator cuff muscles, and it’s not uncommon at all for someone (males especially) to tear or totally separate the two smallest ones by the time you’re in your mid-forties. That’s what I did in both shoulders, and just thought it was normal “getting old” aches and pains. Then moving some heavy equipment I started tearing my right deltoid away from its attachment point at the shoulder. That didn’t hurt too much until the muscle started ripping down the middle, and I lost use of my upper arm.

During surgery to fix the tear, the doc also found that the bicep long-head tendon was damaged to the point where it had to be cut loose and not reattached (bicep tenotomy vs. tenodesis where it’s reattached to the upper arm bone), so my right bicep looks funny now. My upper arm was immobile long enough that all the arm and shoulder muscles associated with it atrophied. Getting them working again took several months, and the 24x7 pain didn’t stop for almost two years.

Today like I said, I have 90-95% range of motion, maybe only about half of the upper arm and shoulder strength, and similarly diminished endurance with that arm. Working above shoulder height is difficult, but I can do it if it’s for a short duration. It’s not pain free, but it’s manageable without Rx drugs, and thank goodness it’s no longer 24x7.

So, you CAN live without some of your rotator cuff muscles, half your bicep disconnected, and a repaired deltoid. But I would never advise anyone which way to go on this. The wisest thing to do would probably be to get a second and maybe even a third opinion. Your age will likely play a big part in what you decide.

:):)