What if my shoulder is still painful or stiff after a Reverse Shoulder Replacement?
Reverse shoulder replacement generally produces good long-term functional outcomes. However, a small subset of patients could have prolonged unexplained pain and limited range of motion (i.e. stiffness) following surgery. Stiffness is one cause of pain which could be from buildup of scar tissue, especially if one has had several prior surgeries. Another cause of pain is impingement or contact between the implant and coracoid, a part of the shoulder blade that extends towards the front of the shoulder. The latter is exacerbated when moving the arm across the chest and behind the back.
Although arthroscopy after replacement is most often employed for diagnostic purposes, we believe it can be used to treat front shoulder pain and stiffness. This arthroscopic technique, developed at Oregon Shoulder Institute, eliminates scar tissue and widens the space between the implant and coracoid, which allows for more contact-free motion resulting in decreased pain. Despite limited studies on this technique, we have successfully decreased pain levels and improved range of motion in our patients.
Figure1. Arthroscopic images showing the space above the rotator cuff (RC) in a patient with stiffness and front shoulder pain. Image A shows dense white scar tissue that is covering the rotator cuff. Image B shows the superior surface of the rotator cuff after clearing the scar tissue.