Our Summary

This study looks at the effects of previous shoulder instability surgery on the outcomes of two types of shoulder replacement surgery: anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA). Researchers studied 38 cases between 2007 and 2018 where patients underwent these surgeries after having shoulder instability surgery, and compared them to similar patients who hadn’t had the previous surgery.

The results showed that both types of replacement surgery were just as effective in reducing pain and improving function in patients with prior shoulder instability surgery, and they didn’t increase the risk of complications or the need for further surgery. However, patients who had aTSA after instability surgery showed worse results in one specific movement (lifting the arm to the side or ‘abduction’) compared to those who didn’t have the prior surgery. But overall, the study suggests that having shoulder instability surgery doesn’t necessarily lead to worse outcomes when you later have shoulder replacement surgery.

FAQs

  1. Does having prior shoulder instability surgery affect the outcomes of anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA)?
  2. Does previous shoulder instability surgery increase the risk of complications or the need for further surgery after aTSA or rTSA?
  3. Are there any specific movements that may be affected more in patients who have had aTSA after instability surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about shoulder replacement is to follow the post-operative rehabilitation plan closely to ensure optimal recovery and range of motion. This may include physical therapy exercises, avoiding certain movements or activities, and attending follow-up appointments with the surgeon. It is also important to communicate any concerns or changes in symptoms to the healthcare provider to address them promptly.

Suitable For

Patients who are typically recommended for shoulder replacement surgery include those who have severe shoulder pain and stiffness that limits daily activities, have not had success with conservative treatments such as medication, physical therapy, or injections, and have conditions such as osteoarthritis, rheumatoid arthritis, or severe fractures. In the case of this study, patients who had previous shoulder instability surgery may also be recommended for shoulder replacement surgery if they continue to experience pain and limited function in the shoulder joint.

Timeline

Before shoulder replacement surgery:

  1. Patient experiences chronic shoulder pain and limited range of motion.
  2. Patient undergoes various non-surgical treatments such as physical therapy, cortisone injections, and pain medications.
  3. Patient consults with an orthopedic surgeon and decides to undergo shoulder replacement surgery.
  4. Pre-operative assessments and tests are conducted to determine the best course of action for the surgery.

After shoulder replacement surgery:

  1. Patient undergoes the shoulder replacement surgery, either aTSA or rTSA.
  2. Patient stays in the hospital for a few days for recovery and post-operative care.
  3. Patient starts physical therapy and rehabilitation to regain strength and range of motion in the shoulder.
  4. Patient follows a post-operative care plan provided by the surgeon.
  5. Patient gradually returns to normal activities and experiences a reduction in pain and improvement in shoulder function.
  6. Follow-up appointments with the surgeon are scheduled to monitor the progress of the shoulder replacement and address any issues that may arise.
  7. Long-term follow-up care is provided to ensure the longevity and success of the shoulder replacement.

What to Ask Your Doctor

  1. What type of shoulder replacement surgery do you recommend for me, given my previous shoulder instability surgery?
  2. How will my previous shoulder instability surgery impact the outcomes of the shoulder replacement surgery?
  3. What are the potential risks or complications associated with shoulder replacement surgery, especially in patients with a history of shoulder instability surgery?
  4. Will I need physical therapy or rehabilitation after the shoulder replacement surgery, and how will my previous shoulder instability surgery affect this?
  5. How long is the recovery process expected to be, and what limitations or restrictions should I be aware of, considering my history of shoulder instability surgery?
  6. Are there any specific exercises or movements I should avoid after the shoulder replacement surgery, given my previous shoulder instability surgery?
  7. How often will I need follow-up appointments or monitoring after the shoulder replacement surgery, and how will my previous shoulder instability surgery be taken into account during this monitoring process?
  8. Are there any specific signs or symptoms I should watch out for after the shoulder replacement surgery, especially considering my history of shoulder instability surgery?

Reference

Authors: Marigi EM, Tams C, King JJ, Crowe MM, Werthel JD, Eichinger JK, Wright TW, Friedman RJ, Schoch BS. Journal: Eur J Orthop Surg Traumatol. 2023 May;33(4):961-969. doi: 10.1007/s00590-022-03233-y. Epub 2022 Mar 1. PMID: 35230545