Should you get a second opinion before shoulder replacement?

Short answer: For shoulder arthritis that no longer responds to injections and therapy, replacement is one of the most reliable operations in orthopedics. A second opinion is about getting the right type of replacement, anatomic or reverse, and the right implant choices for your age.

When a second opinion changes the plan

• You were offered a hemiarthroplasty (ball only). In a randomized study followed for 10 years, 42 percent of total shoulder patients were pain free against none with a hemiarthroplasty, and 90 percent of total shoulders were still in place against 69 percent.
• The rotator cuff status is unclear. An anatomic replacement needs a working rotator cuff; if the cuff is torn, a reverse is usually the better choice.
• You are worried about how long it will last. About 90 percent of shoulder replacements are intact at 10 years and about 80 percent at 20 years, and implant design affects that.

Questions to ask your surgeon

1. Anatomic or reverse, and why for me?
2. Is my rotator cuff intact?
3. What glenoid component will you use, pegged or keeled?
4. Will I go home the same day?
5. When can I return to golf, yoga or my sport?

What your imaging should show

X-rays show the pattern of arthritis and bone wear; a CT or MRI shows the rotator cuff and how the socket has worn. Those findings decide anatomic versus reverse.

What the research shows

Return to activity after replacement is high in Dr. Denard's own series: every yoga patient returned within a year, 80 percent of fishers and 85 percent of shooters returned, and 90 to 100 percent of golfers return in published reviews.

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 total shoulder replacement at Oregon Shoulder Institute.

Frequently asked questions

What is the recovery time?

A sling for about 4 weeks, motion from week 4, strengthening from week 8, and most restrictions lifted around 6 months.

Is there an age limit?

Health matters more than age. Most patients over 65 can expect one replacement to last the rest of their life.

Related reading

• How Long Does a Shoulder Replacement Last?
• Anatomic versus Reverse Shoulder Arthroplasty
• Total Shoulder Arthroplasty or Hemiarthroplasty: Which Is Better?

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.