Shoulder Hemiarthropasty Lessons learned after hemiarthroplasty

[jss]

April 3rd was my ream-and-run. Per the doctor everything went according to plan. He replaced the humeral head with a stemless ball, reamed down the glenoid fossa to shape, reattached the bone shavings and then had the PA close me up. Now the process of healing.

There were a number `lessons learned` once we got home (I'm sure there will be many more).
1. Have them put your t-shirt on you BEFORE the immobilizer is placed, else you have painful spots from the straps rubbing on your torso.
2. Be prepared with the pain medicine. The nerve block lasted 17 hours rather than the 72 that was advertized..
3. When shoulder replacement veterans on this site say to sleep in a recliner, or otherwise sitting up, they know what they're talking about! I slept fine laying on the couch, until the nerve block wore off at 0300, at which time I moved to a reclined position. Though still awfully uncomfortable because the acetaminophen wasn't yet effective, it was FAR more comfortable than being horizontal.
4. Wear the ice machine at night! We removed mine to facilitate sleeping; but I was very swollen this morning.
5. Move around! I sat with the ice machine on for a couple of hours after we got home. We don't watch television and my mental acuity was not yet such that I could resume the book I'm reading; and I was going a bit stir-crazy. We went for a walk in our neighborhood, which did wonders for my mental state.
6. My wife fill be opening my ketchup bottles for a while.

A couple of questions for the veterans out there.
- My first PT session is just two days after surgery. That's not too soon?
- This one's just going to be a little awkward; but we're all adults. When might one expect to be able to resume having sex?

Thanks in advance.

 

[djklaugh]

@jss Congratulations on your shoulder surgery! It is wonderful to hear you are home and doing well.

Re your PT question. That does seem a bit early to me .... but I have had 2 replacement shoulders and PT did not start until about 6 weeks after the surgery. Just be sure PT person does NOT force you shoulder at all! Even with the "ream and run" surgery there is lots of healing to do and you do not want to interfere with that.

And your 2nd question ... sorry I don't have an answer - ask the PT person and/or your surgeon.

 

[dapplega]

Ream and run has a different recovery protocol than TSR. Dr. Matsen, who originated the procedure has patients begin stretching immediately followed by 5x daily stretching sessions to ensure range of motion. There is a good FB group to join comprised of Ream and Run recipients.

 

[jss]

@dapplega thanks. My doctor had me at PT the day after surgery and doing seven sets of stretches, but only twice daily. My PT, who've never heard of 'ream and run' tell me that I'm well ahead of schedule for a TSR. I assume it's because of all of the extra work. I'm expecting to be out of the sling after seeing the doctor on Thursday. Can't wait to be out of it!

As you're recovered from this surgery ... My doctor cautioned me that on average patients get only about 50% pain relief from a ream and run. I might do better or worse, we'd just have to wait and see. What's been your experience? Did you receive a similar admonition from Matsen?

 

[dapplega]

@jss - Matsen did NOT make a 50% pain relief statement. If he had, I'm not sure I would have moved forward. What was stated, and clear from the research, was that it wasn't a 100% guarantee. Some folks don't form the fibrocartilage for whatever reason. Some remain stiff or tight. I'm not a big body builder but do like to workout. I have not regained my former strength (although I hadn't had that strength prior to R&R either). My right shoulder has been more "successful" than the left. It did require one manipulation under anesthesia (MUA) that was performed during my left R&R. This mainly resolved my right shoulder stiffness. My left has been more troublesome. I have had three MUAs and each makes a bit better in terms of ROM. I have a lot of weakness in rotator cuff likely from years of non use or favoring due to the arthritis. It is taking a lot of PT and effort to wake those muscles up. I had the same thing with my glute muscles in my hips. You just don't realize how much certain muscles aren't working properly until you find a good PT. Happy to answer any other questions you have. You are at week 4 of the 6. I do believe the R&R recovery is a lot more grueling than traditional TSR due to the immediate stretching regime. Not sure if you have checked out the R&R FB group. Good discussion there too. PM me and I can give you the link. My best to you.