norm
VIP Member
- Feb 4, 2023
- 55
- 90
It's a long read, but helpful I hope.
In January this year, I finally had the surgery. So far, I can't be more pleased with the outcome. I am convinced it mostly is a result of a great surgeon. If you are in Southern California, I can't recommend more strongly Dr. Roger Sohn, website sohnortho.com
For years, my left shoulder was trouble. No direct injury, but I can only assume it was injured some 15 years ago during a snowboard fall that tore my left triceps tendon off--all good but another story and another great surgeon.
I had limited range, no pain really, just couldn't do things like barbell-behind neck squats, then lat pulldowns, and on. Had several x-rays, MRIs, diagnoses, doctors. Conclusion was basically "frozen shoulder"--that's where the joint cartilage is worn away and the joint gap is very tight. "You'll need shoulder replacement someday", ughh. Had an x-ray-guided cortisone injection into the capsule; that helped for a bit but didn't try it again, the doctor almost couldn't get the needle into the joint. So I made the best of it, adjusting my exercises around the limitations. Later I started getting a "shifting" in the joint where it would physically move into a different "groove" during an exercise. Doctors called this "scalloping" where the bone on bone dishes out several depressions. Disturbing. No pain, but not good so I tried to keep that from happening. The last stage was the joint started to hurt. Kind of an ache. Slowly developed into a constant thing. Couldn't sleep on my side. It sucked. Now I started to look into surgery.
Researched the heck out of it. Google searches, bodybuilder board searches, patient testimonies, anything. There were the traditional procedures, some newer techniques, newer equipment, and even "reverse shoulder replacement". One bodybuilder went through some new procedure where they shave down the joint surfaces which supposedly causes regrowth. Touted as a game changer. His year-long painful recovery sounded horrific; the long-term outcome was unknown. Reject.
Lots of studies to review. What came to light was that the procedure is done mostly on older, inactive people. And the life of the joint was at least 10 years, 15 in many. That's for inactive people. Active, younger people get it done and the joint needs replacing again within 10 years. Discouraging! So I look some more, I stumble on medical device manufacturers with new products. One stood out where the disc portion of the joint is "inset" into the shoulder bone. Existing discs sit on the bone that's flattened and drilled to accept the disc pegs--it is glued into place. All is good except for a phenomenon called the "rocking horse effect". Over time, pressure on the joint disc edges causes it to loosen and start "rocking" ultimately needing replacement. The more active (as in weight lifter), the faster it happens. The Inset disc is set into a round, bored recess in the bone. The entire disc circumference edge is in contact with the bone resulting in a strong mechanical connection; this makes loosening far less possible and studies have shown great success. Check out shoulderinnovations.com
I contact shoulderinnovations to find a local surgeon with experience using their devices. Only two in SoCal--one in LA and Dr. Sohn in San Juan Capistrano. Dr. Sohn was a great find. He has some excellent YouTube videos, patents, papers. My consultation was amazing. His staff is amazing. Excellent communication, diagnosis, took his own in-house x-rays, discussed the "parts" and options---I left feeling this was going to go well. Got some new MRI's and he told me about a partial rotator cuff tear (supraspinatus). Not unusual, but if it fully tears that's what lifts your arm out to the side. One option was to go with the "reverse" shoulder replacement where the mechanical parts are reversed and don't rely on the rotator cuff if it fails. This alters the shoulder geometry. He was 50-50 on either and would support my decision. I researched some more and decided on the regular total replacement. The day of surgery, he asked my permission to also add a cadaver tendon "patch". This would integrate into the existing tendon and strengthen it. I applaud Dr Sohn for considering my long-term outcome and getting insurance approval for this added procedure. Best time to do it since everything is opened up and healing same time.
Recovery was better than expected. I had almost no bruising even though they must cut across the shoulder to expose the joint and separate some muscles. He also re-attached my biceps tendon (long head); not sure if had to be cut during surgery or was damaged before. This tendon goes across the shoulder joint and gets re-attached lower onto the humerus. Overall, pain was low (with percocets) and basically non-existent after a week. Had to wear an arm immobilizer (what a pain), and used an ice-therapy machine for a solid week. I'm sure that thing worked wonders.
Started physical therapy after about a month. Focus was gentle stretching and strengthening. Arm slowly got better. Tried to do any exercises at the gym that didn't use my arm or shoulder---found it's really hard to keep from engaging it in some way but was very careful. At 6 months, Sohn released me for full activity. Range of motion is still limited but I am now free to force that to increase. Working up to previous exercise weights, stretching is very aggressive (painful during) but definite improvements. And no pain! My physical therapist is surprised at my pain-free situation--always was after surgery. Apparently this is not usual, but a great surgeon, and a patient that follows directions and understands anatomy makes all the difference IMO. If you have a shoulder replacement, I hope your outcome is as good.
In January this year, I finally had the surgery. So far, I can't be more pleased with the outcome. I am convinced it mostly is a result of a great surgeon. If you are in Southern California, I can't recommend more strongly Dr. Roger Sohn, website sohnortho.com
For years, my left shoulder was trouble. No direct injury, but I can only assume it was injured some 15 years ago during a snowboard fall that tore my left triceps tendon off--all good but another story and another great surgeon.
I had limited range, no pain really, just couldn't do things like barbell-behind neck squats, then lat pulldowns, and on. Had several x-rays, MRIs, diagnoses, doctors. Conclusion was basically "frozen shoulder"--that's where the joint cartilage is worn away and the joint gap is very tight. "You'll need shoulder replacement someday", ughh. Had an x-ray-guided cortisone injection into the capsule; that helped for a bit but didn't try it again, the doctor almost couldn't get the needle into the joint. So I made the best of it, adjusting my exercises around the limitations. Later I started getting a "shifting" in the joint where it would physically move into a different "groove" during an exercise. Doctors called this "scalloping" where the bone on bone dishes out several depressions. Disturbing. No pain, but not good so I tried to keep that from happening. The last stage was the joint started to hurt. Kind of an ache. Slowly developed into a constant thing. Couldn't sleep on my side. It sucked. Now I started to look into surgery.
Researched the heck out of it. Google searches, bodybuilder board searches, patient testimonies, anything. There were the traditional procedures, some newer techniques, newer equipment, and even "reverse shoulder replacement". One bodybuilder went through some new procedure where they shave down the joint surfaces which supposedly causes regrowth. Touted as a game changer. His year-long painful recovery sounded horrific; the long-term outcome was unknown. Reject.
Lots of studies to review. What came to light was that the procedure is done mostly on older, inactive people. And the life of the joint was at least 10 years, 15 in many. That's for inactive people. Active, younger people get it done and the joint needs replacing again within 10 years. Discouraging! So I look some more, I stumble on medical device manufacturers with new products. One stood out where the disc portion of the joint is "inset" into the shoulder bone. Existing discs sit on the bone that's flattened and drilled to accept the disc pegs--it is glued into place. All is good except for a phenomenon called the "rocking horse effect". Over time, pressure on the joint disc edges causes it to loosen and start "rocking" ultimately needing replacement. The more active (as in weight lifter), the faster it happens. The Inset disc is set into a round, bored recess in the bone. The entire disc circumference edge is in contact with the bone resulting in a strong mechanical connection; this makes loosening far less possible and studies have shown great success. Check out shoulderinnovations.com
I contact shoulderinnovations to find a local surgeon with experience using their devices. Only two in SoCal--one in LA and Dr. Sohn in San Juan Capistrano. Dr. Sohn was a great find. He has some excellent YouTube videos, patents, papers. My consultation was amazing. His staff is amazing. Excellent communication, diagnosis, took his own in-house x-rays, discussed the "parts" and options---I left feeling this was going to go well. Got some new MRI's and he told me about a partial rotator cuff tear (supraspinatus). Not unusual, but if it fully tears that's what lifts your arm out to the side. One option was to go with the "reverse" shoulder replacement where the mechanical parts are reversed and don't rely on the rotator cuff if it fails. This alters the shoulder geometry. He was 50-50 on either and would support my decision. I researched some more and decided on the regular total replacement. The day of surgery, he asked my permission to also add a cadaver tendon "patch". This would integrate into the existing tendon and strengthen it. I applaud Dr Sohn for considering my long-term outcome and getting insurance approval for this added procedure. Best time to do it since everything is opened up and healing same time.
Recovery was better than expected. I had almost no bruising even though they must cut across the shoulder to expose the joint and separate some muscles. He also re-attached my biceps tendon (long head); not sure if had to be cut during surgery or was damaged before. This tendon goes across the shoulder joint and gets re-attached lower onto the humerus. Overall, pain was low (with percocets) and basically non-existent after a week. Had to wear an arm immobilizer (what a pain), and used an ice-therapy machine for a solid week. I'm sure that thing worked wonders.
Started physical therapy after about a month. Focus was gentle stretching and strengthening. Arm slowly got better. Tried to do any exercises at the gym that didn't use my arm or shoulder---found it's really hard to keep from engaging it in some way but was very careful. At 6 months, Sohn released me for full activity. Range of motion is still limited but I am now free to force that to increase. Working up to previous exercise weights, stretching is very aggressive (painful during) but definite improvements. And no pain! My physical therapist is surprised at my pain-free situation--always was after surgery. Apparently this is not usual, but a great surgeon, and a patient that follows directions and understands anatomy makes all the difference IMO. If you have a shoulder replacement, I hope your outcome is as good.
