Should you get a second opinion before a reverse shoulder replacement?

Short answer: A reverse replacement is an excellent operation, but it is irreversible. If you are younger, still raise your arm reasonably well, or have no arthritis in the joint, a second opinion is worth it before the native joint is removed.

When a second opinion changes the plan

• You have a massive rotator cuff tear but no arthritis. In Dr. Denard's comparison of repair and reverse replacement for massive tears with severe muscle damage, both relieved pain, but repair gave more motion: 144 degrees of forward flexion against 113.
• Your weakness is recent. Arthroscopic repair reliably reverses pseudoparalysis when it has been present for less than about 6 months.
• You are younger. Younger patients stress the implant more and have longer for problems to build up, so preserving the joint carries more value.

Questions to ask your surgeon

1. Is there arthritis in the joint, or only a rotator cuff tear?
2. How long have I been unable to raise my arm?
3. Would a repair be possible, and what would happen if it failed?
4. How many reverse replacements do you perform, and what is your complication rate?
5. Will 3D planning be used before surgery?

What your imaging should show

X-ray grading of the joint (Hamada stage), whether the cuff tendons are torn or worn, how many tendons are involved, and muscle quality. Joint preservation is usually possible at Hamada grades 1 and 2.

What the research shows

In a published study of 80 reverse replacements reviewed at an average of 5 years, implant survival was 97 percent and quality of life matched the normal population.

Get a second opinion without the trip

If you already have an MRI, Dr. Patrick Denard can review your images and report remotely and record a narrated video explaining what they show and what he would recommend, typically within 48 hours, for $250. Start a remote MRI review. To be seen in person in Medford or Grants Pass, request an appointment or call 541-608-2595.

Learn more about reverse shoulder replacement at Oregon Shoulder Institute.

Frequently asked questions

How long does a reverse shoulder replacement last?

A published study of 80 reverse replacements found 97 percent still working at about 5 years. Long-term durability is the main reason surgeons are more careful with younger patients.

Can I go home the same day?

Most do. In 2019 and 2020 Medicare data, 88 percent of Oregon Shoulder Institute replacement patients went home the same day.

Related reading

• How Young is Too Young for a Reverse Shoulder Replacement?
• Massive Rotator Cuff Tear With Muscle Damage: Repair or Replace?
• Quality of Life After Reverse Shoulder Replacement

This page is for education and is not a substitute for an exam. Our surgeons have performed more than 10,000 surgeries, and more than 95 percent of patients go home the same day.