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  1. #1
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    Arthritis of the glenohumeral joint

    I'm writing this for posterity's sake in that I don't have any questions. I simply want to have this available to someone who is searching for others who are dealing with glenohumeral arthritis and would like to have a thread to communicate their issues, concerns, experiences, whatever.

    I have been an avid "heavy" lifter for my entire adult life. About 3 years ago I was diagnosed with mild arthritis of the glenohumeral joint with spurring on the inferior head of the humerus. Two years later I had what seemed like a mild injury during seated DB presses but ultimately resulted in a dramatic loss in ROM in the arthritic shoulder over the next month. The original diagnosis was adhesive capsulitis secondary to osteoarthritis. Another year and a half goes by and the ROM does not improve. Further imagery reveals that the spur has grown massive, "one for the text books" I think was the word and I have lost almost all of my articular cartilage. Although I was not experiencing much pain the severely decreased ROM was affecting my quality of life. I was not responsive to physical therapy.

    One month ago I had arthroscopic surgery to excise the bone spur and release the inferior 180 degrees of the joint capsule. At this point I have improved the ROM with very aggressive physical therapy (5 days/week) but am experiencing quite a bit more pain through all range of motion than I was preoperatively. Hopefully I will continue to improve but feel to be doing so very slowly. Reading the stories of subacromial decompression and similar bone work leads me to believe that operations involving bone in and around the shoulder are inherently long recoveries (in terms of pain).

    The reality is that I will be a candidate for shoulder replacement, timing unknown. I'm hoping I will be able to maintain a sufficiently intact joint to be a candidate for resurfacing, which appears to be the best option for someone of my activity level and age. I have no idea what types of activities are realistic following this procedure. Weight lifting, sure, but weight lifting like a circuit trainer, or weight lifting like someone who wants to push themselves well beyond anything resembling average.

    If anyone has gone down the road of osteophyte (due to GH arthritis) removal, recovery, and replacement or resurfacing I'd appreciate hearing from you in this thread or via PM.
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    Registered User shannonoree's Avatar
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    What's up bro. I am sorry to hear you have arthritis. I have GH arthritis in both my shoulders and AC joint arthritis in my left. I have degenerative tears in my labrums. I will tell you all about it if you want to know. I see this post is an old so I will wait till I get a responce before I lay it all out there. I am 32 years old, so this has been a huge setback. I have been very active all my life until now. Let me know if you are still out there.
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    Originally Posted by shannonoree View Post
    What's up bro. I am sorry to hear you have arthritis. I have GH arthritis in both my shoulders and AC joint arthritis in my left. I have degenerative tears in my labrums. I will tell you all about it if you want to know. I see this post is an old so I will wait till I get a responce before I lay it all out there. I am 32 years old, so this has been a huge setback. I have been very active all my life until now. Let me know if you are still out there.
    Yep, still here!!

    Both shoulders? I'm really sorry to hear it. How... due to old labrum damage? Where are you, disease-wise (early stages, late stage, etc.)? Have you had any work done on them yet?
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    Registered User shannonoree's Avatar
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    Not really sure how it happened. I lifted a lot of weights when I was in my early 20's. My doctor says it was probably a result of some type of cartilage damage that was left untreated. Probably bad lifting technique when I was young. My activity level WAS really high until early this year. I would grapple 1.5-2.5 hours a day 4-5 times a week. I did that for years. As I’m sure you know, once you get a rough spot on your cartilage it sets up the degenerative process. Given enough time and activity, it will wear the joint out. That’s what happened. My shoulders hurt a little for a long time, but it got really bad over the course of 3-4 months.
    I had surgery on my left shoulder back in April. The doctor put the scope in and looked around and closed me up. He said there was nothing that could be done because my damage was to advanced. He did remove a spur while in there. I elected not to have the surgery on my right because the doctor said, based on the MRI, that it was at least as bad as my left and could not be fixed.
    This has devastated my life style. I had to quit BJJ and wrestling. Weight lifting is pretty much out of the question. I can hardly lift my arms over my head. Everything hurts my left arm. My right arm doesn’t hurt as bad but I still have problems with it. I have been strong and active my whole life. I don’t know what I am going to do. I am thinking about have a shoulder replacement on my left side. My orthopedic doctor told me I was a candidate for replacement if I chose to do it.
    How about you? Have you been able to make any sort of recovery? Is it better or worse? I included my comments off my MRI for you to look at. You can see how they match up to yours.
    Right Arm
    1. Moderate degenerative change to the glenohumeral joint with moderate to high grade cartilage loss to the posterior half of the glenoid and mild to moderate cartilage loss to the adjacent humeral head. Associated subchondral cyst formation noted to the glenoid. Mild AC joint degenerative change present.
    2. Nondisplaced tear of the posterior/inferior labrum with small paralabral cyst formation noted. Degenerative type tear suspected to the anterior/inferior labrum at the labrum/cartilage interface.
    Left Arm
    1. Degenerative changes to the glenohumeral joint with moderate articular cartilage along the posterior half of the glenoid and underlying subchondral cyctic change noted.
    2. A linear tear of the posterior/superior labrum with deficient appearance noted to the posterior/inferior labrum suggesting degenerative type tearing.
    3. Mild supraspinatus tendinopathy with no significant tear appreciated to the rotator cuff.
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    Yes, if I had to put money down I would say the number one contributor to your degenerative arthritis is the extensive damage to the labrum in each shoulder. Without the ability of the humerus to stay stable and centered in the joint there will be excessive point loads that will result in premature damage to the cartilage. The number one difference between us is that my labrum is in pretty good shape - no obvious tears, just the usual wear & tear fraying. My MRI and x-ray readings had a lot of words like "severe" "advanced" and I think even one reading had "catastrophic" when describing the extent of the damage to the cartilage & bone. I also had/have a subchondral cyst on the humerus (not glenoid).

    I was in constant extreme pain this time last year. I quit doing any real overhead work and stopped doing heavy barbell presses. I gave up incline BB presses altogether. I simply do not have the external rotation and the capability to comfortably elevate over my head. What ends up happening is that my entire shoulder blade rotates or hikes to produce the desired movement. The body was not designed for this and it ends up doing more damage, especially under the weights. I went through months and months of PT and that didn't do squat. I had a debridement of the joint, including a removal of some portion of the massive osteophyte that was growing, but that really didn't help much either. Giving up the big pressing movements (you can check out my journal, the link is at the bottom of the signature, if you want to see the type of work I do now) with the bar really relieved me of a lot of pain. I also take my fish oil, MSM/Glucoseamine sulfate, and when necessary, celebrex or naproxen. The shoulder aches more times than not but it's not horrible. Now, if someone grabs my arm and tries to pull it the wrong way, that'll bring me to my knees.

    I just spoke to a guy who had the copeland resurfacing done (ask your doctor about it). The Copeland resurfacing is where they basically just put a metal cap on the head of the humerus and leave the glenoid alone. More severe forms of arthroplasty include hemiarthroplasty (also put a cap on the glenoid side) or total shoulder arthroplasty (TSA) where they cut the head of the humerus off and replace the whole thing as well as capping the glenoid. Anyway, the guy I spoke to was about 42 and very active (Navy, crossfit, etc). He was extremely happy with the results of the resurfacing and said he was able to go back to doing most everything he was doing before the arthritis got bad. He claims he can do pullups, dips, and even punch without any pain. I couldn't say whether or not you'd be a candidate for it, that's up to your doctor. I'm not as familiar with possible contraindications for the Copeland related to the labrum. Keep in mind the damage can get so bad that you lose the ability to have that procedure done, especially if the glenoid gets too badly damaged.

    So, I still work out and work out hard. While the actual damage to the bone and cartilage sounds a little bit worse for me the overall condition of your shoulder is worse than mine. I cannot lift my arm over my head and have NO external rotation without excruciating pain. I have no illusions that this will get better. It's an issue of pain management and putting off the inevitable as long as is reasonably possible. With the change in lifting routine and the anti-inflammatory medication I'm actually pretty comfortable now. I will continue on this path until either the pain gets too bad or my glenoid starts showing signs of excessive wear (that is, I lose the option of getting the copeland procedure). I go in every few months and get an x-ray to check out the condition of the joint.

    Everyone experiences pain very differently. The PT and surgeon cannot believe I can lift anything based on the appearance of my films. I don't have the heart to tell them that my chest day, for example, usually involves nearly 100 reps of 100# flat DB presses. Other than being a little crooked in the motion it doesn't bother me a bit. Others may have a lot less visible damage and be in unbearable pain. My physician claims that pain, rather than the appearance of the joint, is the indicator for when it's time to have some sort of arthroplasty. Considering how young you are I would go with the least extreme possible form of arthroplasty, recognizing that you will probably have to have some sort of revision surgery down the road. A TSA seems like it would probably have the biggest issue for an active person in that it can work loose pretty easily.
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  6. #6
    Registered User shannonoree's Avatar
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    Well I thought I would give you an update on my shoulder. I am having TSA April 4. I went and say a shoulder guy here in Memphis the other day. He said due to my wear that I couldn't get the hemiarthroplasty. He said the only option for me is to get a total replacement. Looks like I also need one for my right arm as well but we will be doing my left on April 4.

    I really didn't want to do it but I don't have a lot of options at this point. I can take anti inflammatory medications and they do help a good bit, but they have a lot of side effects associated with long term use. I spoke to my family doctor about taking the meds and he told me that I would be better off getting the surgery than taking the meds long term. He said that they risk of stomach and heart related problems is pretty small in short term use, but, the longer you use the meds, the higher the probability you will have issues. I am 33 so I am looking at using the meds for many many years. So with all that in mind, I decided to have surgery.

    The guy doing my surgery said he does about 150 shoulder replacements a year. It’s pretty common knowledge that it is better to use someone who does a lot of surgeries if you want the best outcome. Shoulders is all this guy does and he is good at it by all accounts. I asked him how someone my age gets severe arthritis. He said the real reason is unknown. He said you hear a lot about “wear and tear” but that theory has a lot of holes in it. He said if wear and tear were the reason for arthritis, all pitchers, football QB’s, and tennis plays would need shoulder replacements. He said it’s probably a combination of genetics and use. He also said I am not his youngest patient.
    I will be starting a youtube video “diary” to document the entire process. I ‘ve searched the net and can hardly find any info for people my age. I want to let people know how the whole process works. I go for another arthrogram this Friday and will start my videos then. I’ll let you know how it goes. Take care
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    Hey, sorry to hear that you had to go the full TSA route, but if that has the best prognosis then it's the right thing to do. You are definitely right about the lack of information for younger people and the video sounds like a great idea. I suppose I could do the same when the time comes. It's kind of weird opening up such a personal aspect of one's life but considering how hard it's been for us to find any information it'll probably help a lot of people deal with the situation.

    You are the third or fourth person I've encountered who has been discouraged from the partial replacements which scares me a little bit. I've seen some pretty nasty should x-rays from people with advanced arthritis and I am not that bad, but I worry that I will get fly right on past the less severe option. On the other hand, I get the impression that the decision process is somewhat a function of the individual OS. Some seem more inclined to push the partial replacement more than others. Either way, this is the card we've been dealt. At least there are options.

    I take it your pain is pretty severe and continuous? Other than having really poor ROM I'm not in that much pain. If I over-rotate or over-elevate the shoulder it's just about the worst pain ever but otherwise it's not too bad under normal conditions. I get setup with a good stack of pillows at night and sleep fine. I only take advil or Celebrex every now and again. I'm a little worried that being in a constant inflammatory state isn't good for my body though. It definitely affects the immune system and overall well being.

    Let me know how things go. Best of luck to you.

    PS - You're not too far from me. I'm having mine done, when the time comes, by Dr. Kuhn in Nashville, TN. I'd be willing to bet your OS knows him.
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    Registered User shannonoree's Avatar
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    You know the funny thing is with my arthritis is that the pain kind of comes and goes. I have weeks where I hurt a lot, but then I will have weeks where it doesn’t bother me too much. It always hurts overhead or with heavy lifting. If I was content to just sit around and do nothing all the time, I probably wouldn’t need to have surgery. I’m an aircraft systems engineer so I sit at a desk all day. The biggest problem for me is that I can’t do much of anything without pain. Even simple things like sweeping the floor will make me so sore I can barely scratch my own head the next day.

    Like I told you before, I trained and competed in jiu jitsu and wrestling up till about a year ago. I lifted weights when I was younger but not to much the last few years. My big thig was grappling. I grappled 4-5 times a week for years. I loved it and it was really hard to let go. At this point, I will be happy just to be able to go fishing or wrestle around with my kids without hurting.

    My doctor said he does all different kinds of shoulder replacements. He said as a general rule, the partial shoulder replacements that use the “button” like the Copeland are only for people with arthritis limited to the humorous. You still might not be able to get it if the bone wears away to much. We did talk about the hemiarthroplasty. As you know, they replace the head of the humorous just like a TSA, but don’t replace the socket. They will resurface the socket and let the bone rub on metal. My doctor says you don’t get consistent pain relief with the surgery. He said sometimes he does a hemiarthroplasty and lines the socket with cadaver meniscus. This is called a hemiarthroplasty with a biological resurfacing. He said he does all these surgeries but typically recommends TSA because you get the best results most of the time.
    He said they use a lot better materials now days. He said 85% of TSA’s last 20+ years. He also said 90% of people have no problems and are happy with the results. Complications are not common and you end up with 75-80% normal range of motion. He said the recovery will be 3 months, but I could see improvements for 12 months.

    So that’s my story. Even though our circumstances are different, we share a common problem. I looked for months before I found anyone else even close to my age with arthritis. I’ll shoot you a private message and send you my email address. I have another arthrogram this Friday and surgery April 4. I'll let you know how it goes. I’ll ask my doctor if he knows your guy. The guy I’m seeing is Quinn Throckmorton and the Campbell Clinic in Memphis. Take it easy.
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    Originally Posted by shannonoree View Post
    You know the funny thing is with my arthritis is that the pain kind of comes and goes. I have weeks where I hurt a lot, but then I will have weeks where it doesn’t bother me too much. It always hurts overhead or with heavy lifting. If I was content to just sit around and do nothing all the time, I probably wouldn’t need to have surgery. I’m an aircraft systems engineer so I sit at a desk all day. The biggest problem for me is that I can’t do much of anything without pain. Even simple things like sweeping the floor will make me so sore I can barely scratch my own head the next day.
    Yeah, I'm exactly the same way. Raking the lawn is almost unbearably painful but I can bang out 10x10 on 100# DB presses and not be bothered at all. Strange.

    Like I told you before, I trained and competed in jiu jitsu and wrestling up till about a year ago. I lifted weights when I was younger but not to much the last few years. My big thig was grappling. I grappled 4-5 times a week for years. I loved it and it was really hard to let go. At this point, I will be happy just to be able to go fishing or wrestle around with my kids without hurting.
    Right there with you. I have to be really careful with my boys. If they throw themselves into my bad shoulder and make my arm rotate out I see stars. Kinda pathetic for daddy to be so beat up he can't rough house or even throw a ball. I'm afraid my kids will be calling me grandpa by the time they are 10!

    My doctor said he does all different kinds of shoulder replacements. He said as a general rule, the partial shoulder replacements that use the “button” like the Copeland are only for people with arthritis limited to the humorous. You still might not be able to get it if the bone wears away to much. We did talk about the hemiarthroplasty. As you know, they replace the head of the humorous just like a TSA, but don’t replace the socket. They will resurface the socket and let the bone rub on metal. My doctor says you don’t get consistent pain relief with the surgery...
    This is interesting to me and I've heard the same from my doctor. He is totally focused on pain management and I'm focused on functionality. Obviously in the extreme these two are one in the same but if I can reach and press over my head even with moderate pain I don't mind. As it stands right now it's completely impossible.

    I'd still like to be able to do deadlifts and things like that even if BB benching or even overhead presses are no longer in the cards. I wonder how well a stem implant would hold up under those kind of loads?

    So that’s my story. Even though our circumstances are different, we share a common problem. I looked for months before I found anyone else even close to my age with arthritis. I’ll shoot you a private message and send you my email address. I have another arthrogram this Friday and surgery April 4. I'll let you know how it goes. ....
    Yeah I hear you. Got the PM and your email and will keep an eye out for the video.

    Best of luck.
    Last edited by mslman71; 03-13-2012 at 06:35 PM.
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    I'm in the same boat. Interested in the video logs. Where can they be seen. up for shoulder and hip replacement after 30 years of lifting. Doing hips first as I understand weight not as limited. Shoulders hurt, but have high tolerance...unless I hear you 're doing 225 front BB presses!!

    Best,

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    Amazing it's been two years since I started this thread. I've lost some pressing ability, or maybe it's more accurate to say that I've taken it easier on the pressing movements. Aside from the secondary SC strain things have not gotten much worse (or better). I can still manage productive lifting sessions and other than the reduced ROM I'm trucking along reasonably well. It's been a year since my last x-rays so no telling what the joint looks like now. Hopefully I can stick it out for another two years.
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    Gday mate just wondering how you went with your problem ? I'm in the same boat
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    Originally Posted by terryagius View Post
    Gday mate just wondering how you went with your problem ? I'm in the same boat
    I've managed to stretch it out for almost 4 years now. It's very much on its last leg. I've had to drop all bar work - no pulling or pressing. Also can't handle a lot of pressure for tricep work or pulling for bicep work. I've spoken to the surgeon and hope to schedule the replacement for this year once I get a few other personal things completed (like finishing up my home renovation - need a functional arm). It suddenly got worse a few months ago and I think what's happened is that the joint has lost enough of its concentricity that it's now pressing on the soft tissues in the joint space. If I don't act soon I'll probably end up doing damage to the RC and the LHB tendon (I'll have the LHB tendon relocated as part of the procedure anyway).
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    In on the future arthritic shoulder and future replacement :P
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    Bone on Bone In Shoulder

    Originally Posted by mslman71 View Post
    I've managed to stretch it out for almost 4 years now. It's very much on its last leg. I've had to drop all bar work - no pulling or pressing. Also can't handle a lot of pressure for tricep work or pulling for bicep work. I've spoken to the surgeon and hope to schedule the replacement for this year once I get a few other personal things completed (like finishing up my home renovation - need a functional arm). It suddenly got worse a few months ago and I think what's happened is that the joint has lost enough of its concentricity that it's now pressing on the soft tissues in the joint space. If I don't act soon I'll probably end up doing damage to the RC and the LHB tendon (I'll have the LHB tendon relocated as part of the procedure anyway).
    I have terrible arthritis in both shoulders with bone on bone in my left. I have worked out for years but mostly body weight moves - hindu push ups, push ups, pull ups, chin ups, dips and various ab exercises.

    I had my first steroid shot in the should two days ago. Should I even attempt any of my old body weight moves that involve the shoulders or can I continue with my routine but remove hindu push ups? It will be devastating if I cannot work out like this any longer.

    Any info/feedback/thoughts please pass them along. It's great to hear you have been able to stretch it out so long. I plan to do the same but my concern is can I continue working out until a full replacement?

    Cheers and good luck!
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  16. #16
    Registered User pbnycmuscle's Avatar
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    Also facing Total Shoulder Replacement

    I'm afraid I can't hold out much longer with the TSR surgery. The pain has gotten almost unbearable. I'm wondering if anyone on this thread had the surgery and what the recovery was like. Have you been able to workout at all without risking damage?

    Any updates on your situation(s) would be much appreciated.
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    Registered User 92122's Avatar
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    Before you undergo a total shoulder replacement, check out the "ream and run" procedure. Dr. Matsen from U Washington pioneered it but a few others do it as well.

    Ream and run is different in that while you get a humeral head replacement, the glenoid is simply reamed clean and left alone. This allows you to work out without concern for glenoid component loosening.

    Good luck!
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    Registered User 92122's Avatar
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    Another option, this one all-arthroscopic, is by Reuben Gobezie, MD. I cannot post links so google him.
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    Thanks for the options!

    I appreciate these options. I'm going to look into them. It looks like they may be more on the experimental side and not covered by insurance though. I'll definitely check it out though. Thanks!
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  20. #20
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    How are you guys doing today? got the TSR?
    I had cartilage damage on the GH joint this year, how long will take to develop this painful arthritis?

    Should I avoid any exercise now to prevent?
    learning english so take it easy guys
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    Unhappy My story - 26 yr male - arthritis, shoulder reconstruction,debris

    Hi BB Community!

    Thanks for sharing your stories.
    I just booked in surgery for my second shoulder reconstruction for my right shoulder. According to my Specialist "Dr. DesmonD Boker" in Australia, it seems like after he reconstructed/tighted the front of my shoulder, the back has also started to come loose (weird, i know...).

    Additionally, similarly to a few of you, I have remaining debris in there (around 5mm in size) that's apparently damaging and progressing arthritis.
    I initially hurt my shoulder while playing indoor football as a goal keeper and landed on it with my arm down by my side, during the fall, it stuck to the ground and subluxed/tore the labrum. During the impact, it seems to have broken a lot of the gleno joint stuff? (not good with the technical wording), the part that is meant to look silky and smooth now looks red/cracked/shredded apart - pretty messed up...

    Since the initial injury (4 years ago), to now, it's never been above 65% working capacity, it fatigues quickly, ROM is decent but going across my body hurts, the o'brien's test(hand across and palm up as if i'm pouring out a bottle of water) is SUPER weak, like... i can't even hold up my phone in that position.

    My surgeon said if it is as bad as what he suspects based on the MRI scans, i won't be able to do weights again nor even body weight things like push ups.
    Anyways, i'm writing this quite taken back as I was only told this news about an hour ago....

    My shoulder still hurts now but i can still do high intensity work outs, my back is strong, bench is strong enough but has some pain, i wonder if getting all this surgery will take me back to a better place than where i am now or if it'll make it MORE painful but more stable...

    Anyways, that's my sad story for a 26 year old male...
    1 fall was all it took zzz -.- guess it teaches us perseverance and teaches us to appreciate the things other people can easily take for granted. (however, it still sucks aye...)
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    Originally Posted by Inrhee View Post
    Hi BB Community!

    Thanks for sharing your stories.
    I just booked in surgery for my second shoulder reconstruction for my right shoulder. According to my Specialist "Dr. DesmonD Boker" in Australia, it seems like after he reconstructed/tighted the front of my shoulder, the back has also started to come loose (weird, i know...).

    Additionally, similarly to a few of you, I have remaining debris in there (around 5mm in size) that's apparently damaging and progressing arthritis.
    I initially hurt my shoulder while playing indoor football as a goal keeper and landed on it with my arm down by my side, during the fall, it stuck to the ground and subluxed/tore the labrum. During the impact, it seems to have broken a lot of the gleno joint stuff? (not good with the technical wording), the part that is meant to look silky and smooth now looks red/cracked/shredded apart - pretty messed up...

    Since the initial injury (4 years ago), to now, it's never been above 65% working capacity, it fatigues quickly, ROM is decent but going across my body hurts, the o'brien's test(hand across and palm up as if i'm pouring out a bottle of water) is SUPER weak, like... i can't even hold up my phone in that position.

    My surgeon said if it is as bad as what he suspects based on the MRI scans, i won't be able to do weights again nor even body weight things like push ups.
    Anyways, i'm writing this quite taken back as I was only told this news about an hour ago....

    My shoulder still hurts now but i can still do high intensity work outs, my back is strong, bench is strong enough but has some pain, i wonder if getting all this surgery will take me back to a better place than where i am now or if it'll make it MORE painful but more stable...

    Anyways, that's my sad story for a 26 year old male...
    1 fall was all it took zzz -.- guess it teaches us perseverance and teaches us to appreciate the things other people can easily take for granted. (however, it still sucks aye...)
    Been there, done that.

    Almost never will the scope fix stuff like this. Best that you hold off and continue to do what your body will allow you to do. In the event that you need a replacement, you will appreciate not having the scar tissue that will accumulate from even an arthroscopic procedure.

    In general, redo surgery is fraught with peril and the underlying issue foils whatever is being done. Also, posterior labral tears that are chronic, which is what this has become, are not fixed nowadays as the tightening itself is associated with DJD. You have the beginnings of this now.

    Surgery won't prevent or even stave off DJD. Maybe you can put the procedure on hold and see how things go before undergoing another operation.
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