In April I slipped on a rock while trying to find a place to bury our cat, ending up upside down with my full weight hitting our well house wall with the top of my shoulder. I have a pacemaker so the ER could not do an MRI, but they X-rayed it and said it was a sprain. My PCP prescribed physical therapy and after they did the initial evaluation they concluded that I had not damaged the rotator cuff. After a dozen PT sessions, the shoulder did not hurt as much but the upward range of motion to the side was seriously limited and I could pick up only a pound or two.

In August I saw the very capable local orthopedic surgeon who did one of my knee replacements. He ordered an X-Ray arthogram, which revealed that the rotator cuff was torn and irreparably damaged. He suggested that I needed a shoulder replacement and that I should go to Dr. Michael Wirth, a shoulder replacement specialist, at the UT Medical School in San Antonio, 40 miles south of us. Saw him on Thursday and had more X-rays, which plainly showed that the upper end of the humerus is out of and significantly below the socket. I then understood the popping and the feeling that the arm was jumping out of the socket that occurs when I turn the steering wheel of the car to the left or reach behind my back.

The surgery is not yet scheduled but will be done before the end of the year. I bounced back quickly from my two knee replacements so would not expect this recovery to be any more difficult. However I would appreciate hearing the experience any of you have had with this surgery as I am my wife's caregiver and do not anticipate using outside help. The surgeon said two days in the hospital, three months recovery time, a short time to drive, etc.

Thanks in advance.

I've heard that the shoulder is WAY more complicated - do LOTS of research.

hal

I appreciate the advice. Something has to be done as the rotator cuff is totally torn apart and the upper end of the humerus is rubbing on other bones which will cause problems if not fixed. Dr. Wirth's credentials are very good and I have confidence in him. Here is a link to his information page at UT Health Science Center.

[orthopaedics.uthscsa.edu]

I would get a second opinion to confirm the procedure. If the second opinion concurs, you're fine to proceed. If it doesn't, you know to ask more questions and maybe get a third opinion. Good docs welcome second opinions. I hear the shoulder takes a bit of time to recoup after surgery. Some people don't want to go through this trouble but I personally wouldn't proceed any other way.

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JoeM

Well, I was told I needed a shoulder replacement about four years ago. I have been doing lots of research since then and am finding out that all replacements are not the same or done for the same reasons. When I was 27, I had a very bad dislocation while skiing and was told that in 30 or 40 years I may have some issues. He was right, bad arthritis build-up, much pain and little movement.

The doctor I saw four years ago was not recommending the surgery because he knew I was active and he said the operation limits your usage for the rest of your life. Like I would not be able to lift anything over 35#s...ever.

I was also told that since shoulder replacements are relatively new, they are finding that failure rates are high after seven years.

Find out how many this guy has performed, talk to some of his patients, talk to other doctors.

My pain is constant and I will be having the operation at some point and it may involve a trip to Seattle since there is a doctor there doing a different sort of replacement that has been getting incredible reviews.

Your operation sounds different from mine, since I'm being told it is almost a year of rehab for me. Yes, a few days in the hospital, but a month or more of no driving.

You don't mention your age, I'm guessing that is a factor, also. I just turned 65 and will probably have the operation next year since I'm working on a huge project right now and can't take the time.

Good luck with whatever you decide. I wish you well.

Orthopedic procedures often follow the "everything's a nail when you're a hammer" principle. Go to s surgeon who cranks out the spinal fusions, you need a spinal fusion. Go to a surgeon who cranks out knee replacements, you need a kn ee replacement... etc. Not to say that this surgeon is wrong, but I can't figure out how a Physical Therapist could miss a rotator cuff tear of that reported magnitude.

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New forum user map 8/2015: [www.zeemaps.com]

JoeM - Dr. Wirth, the one I saw the most recently, was the second opinion. The first one was the local surgeon who is THE one locally to do knee replacements who referred me to Dr. Wirth. He said he could do the shoulder replacement but would rather I had it done by a surgeon who specializes in them and is recognized for his leadership in the field. Thus his recommendation to go to Dr. Wirth. I seriously doubt that there is another should replacement specialist in the San Antonio area who is as well qualified and going to another major city (Houston or Dallas) is out of the question.

studio - Sorry I forgot to mention my age. I will be 76 next month and am in relatively good shape, though I had a triple bypass and aortic valve replacement 6 years ago. My father and his father lived to be 86. My mother, who will be 98 next month, is in good shape except for a bad knee. Both her parents lived into their mid nineties. I realistically only need the replacement to last 10 years.

As for lifting things after replacement surgery, I can only lift a few pounds to the height of my shoulder so anything beyond that will be a blessing.

studio - thanks for your thoughts.

Black - try the link for Dr. Wirth's page. He's not a one trick pony. Here is an excerpt.

Michael A. Wirth, M.D., Professor of Orthopaedics and The Charles A. Rockwood, Jr., MD Chair on the Shoulder Service of the Orthopaedic Department of UTHSCSA, specializes in the treatment of traumatic and atraumatic injuries to the shoulder. These include single and complex fractures of the shoulder, recurrent subluxation/dislocation of the shoulder, involuntary and multidirectional instability of the shoulder, rotator cuff tears, shoulder impingement syndrome and frozen shoulder, as well as degenerative and arthritic problems of the shoulder. Dr. Wirth’s treatment protocol includes both non-operative and surgical strategies, including a pre and post-operative home based exercise program for rehabilitation of the shoulder. His surgeries include total and hemiarthroplasty (total or partial replacement of the shoulder), Reverse total shoulder, capsular shift reconstruction, rotator cuff repair, sternoclavicular joint repair, revision of shoulder arthroplasties and arthroscopic procedures.

Looks like Dr. Wirth knows what he is doing. I think if I were in your situation, I would probably move on it. Make sure you understand everything he would be doing. The only thing I can say about the reverse total shoulder that is mentioned in his resume, is that a friend had that done and it was a total bust. He had to have it re-done in six months. He says the only good thing is that there is no more pain but he has hardly any movement. This may sound weird, but he's not symmetrical anymore...his bad shoulder is higher than the other and sticks out more. It's too bad since he is a potter and has to use one arm to lift the other so he can work.

OK, I know nothing about this. However...

You may do well to visit a really, really good therapist (massage myofascial) who could work for you over time. It's worked for my back, and my injuries to it when I was in my 20s sound similar to what you went through, although a big age difference, I do realize. Surgery is always and should always be a treatment of last resort.

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Mischievous and Deceitful
Chicanerous and Deplorable

mrbigstuff - as noted win the original post, I had 12 sessions of PT with the very professional Christus Santa Rosa Hospital therapy facility in May. It helped but no therapy will heal the destroyed rotator cuff and continuing without surgery will just cause future problems with the humerus out of its socket. I've done all the preliminary stuff, am tired of having a useless left arm, and am now needing to go the surgical route.

Those who have not experienced a torn rotator cuff may not understand that it is not only the daytime activities that cause distress, but also the simple act of trying to sleep. I had a nearly irreparable rotator cuff tear repaired. They told me it would have a great chance of tearing again. I believe it has. I would do the replacement surgery if I were you. My brother-in-law had it done and is very pleased with the results.

Good luck ! There are days I wish they had put in new hardware instead of the screwed and riveted together assembly I have now. Everyone I know who has had a joint replacement says the same thing ... The joint pain is gone ! Ok , I have all the same OEM bits plus add on hardware , but the pain is constant.

I have had no problems with my knee replacements done in 2005 and 2010. Am hoping the shoulder will go as well.

Quote
mjgkramer
mrbigstuff - as noted win the original post, I had 12 sessions of PT with the very professional Christus Santa Rosa Hospital therapy facility in May. It helped but no therapy will heal the destroyed rotator cuff and continuing without surgery will just cause future problems with the humerus out of its socket. I've done all the preliminary stuff, am tired of having a useless left arm, and am now needing to go the surgical route.

you had 12 sessions over the course of one month? it took me probably two years to feel better by going to this particular massage therapist, about once or twice per month (some healing needs to take place in the interim) but I understand you are in a bit of pain and lack of sleep will drive one nuts.

but healing may be a very slow process and the back can't be any quicker than a rotator cuff in this regard.

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Mischievous and Deceitful
Chicanerous and Deplorable

Well some of you might remember that I had 3 level Spinal Fusion 6 years ago. I had 2 surgeons and a pain
specialist tell me that I needed surgery. I found, after much research, one of the top spinal surgeons on the
east coast, supposedly. He is also chief of neurosurgery over a large conglomeration of hospitals here in NC.
It took 6 months to work me into his schedule for my surgery. So I patiently waited and the day finally came.
I had the surgery, was in the hospital for 5 days, was not suppose to be there that long. Anyway the surgery
was a failure. It left me with nearly as much back pain as before and a new problem, a partially numb left
leg and foot.

Along with my leg and back problems I have Spondylosis aka: Degenerative Disc disease, Spinal Stenosis
(narrowing of the spaces between the vertebrae), arthritis of the spine and 2 more bulging discs. With all
this and Meniere's Disease and I now walk with the aid of a cane, walking stick or if taking longer walks
outside, I use 2 walking poles.

Now here's what I'm getting at. The surgeon that was suppose to do my surgery is not listed anywhere on the paperwork
I received from the hospital, another Drs. name that's in the same practice is listed on all the paperwork.
My sister works for a group of surgeons and says this happens all the time. If a surgeon gets a trauma call or just
isn't feeling well that day they will have someone else do the surgery and I believe this is what happened
in my case but I would never be able to prove it. I was out cold before I went back for the surgery and don't
remember seeing or hearing anything past you're going to wake up in about 5 hours and be all fixed up.
Well it took me over 10 hours to wake up but that's another story.

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Grateful11

I am starting pt for a rotator cuff plus operation .
I am 81. Have Parkinsons ... Very rough for me. Never offered replacement.

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A man who is of "sound mind" is one who keeps the inner madman under lock and key.
(Paul Valery)

Go To Top - My rotator cuff is beyond repair so it is either be crippled for my remaining 10 years or so of life or have a replacement and hope it is better than what I have now.