Phoenix Shoulder Ledger
When is shoulder replacement worth discussing?
Write down which important tasks your shoulder now stops. Include sleep, dressing, driving and reaching into a cupboard. These facts make a surgery talk much clearer. An x-ray can't choose the right time for you.
Discuss replacement when daily loss feels harder than surgery and recovery. The first talk doesn't require a decision.
How do I know that waiting isn't helping?
Look at what changed after home care and therapy. Note whether relief lasted or quickly faded. You may still feel comfortable enough to wait. Repeated lost sleep and trouble dressing deserve another talk with your doctor.
Base the timing on your daily life, not just the x-ray report.
Can I consider nonsurgical care while I decide?
Yes, when a doctor says your shoulder is safe to keep using. QC Kinetix can discuss orthobiologics, the medical name for nonsurgical choices made with your blood. One choice is platelet-rich plasma, the portion left after a machine separates your blood and gathers more platelets. It's used to try to ease soreness and help you use the arm.
These choices don't replace urgent care. They also don't replace seeing a surgeon when your shoulder may need surgery.
What do I ask about replacement?
Ask which operation fits your joint and nearby tendons. Ask how long recovery takes and what problems can occur. You'll also want to ask whether another operation could be needed later. If the reason or timing isn't clear, another surgeon's view may help. Bring your x-rays and describe the loss in daily use. Ask whether surgery could improve a task you value.
A clear answer explains why surgery makes sense now or why waiting is sound. It won't rely on your x-ray alone.
Sources
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A systematic review of seven case series (469 reverse total shoulder arthroplasties, mean age 71, mean 12-year follow-up) found weighted mean revision-free implant survivorship of 88% at 10 years, an overall complication rate of 36% and revision in 23% of patients - most often for infection (8%), instability (7%) and glenoid complications (3%) - alongside large functional gains (absolute Constant score 27 to 62).
Biner M, et al. — Long-Term Outcomes Following Reverse Total Shoulder Arthroplasty: A Systematic Review with a Minimum Follow-Up of 10 Years.. JB JS Open Access, 2025. DOI: 10.2106/JBJS.OA.25.00025.
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An Australian national joint registry analysis of 1,564 shoulder arthroplasties done for osteoarthritis in patients UNDER 55 found reverse total shoulder arthroplasty had the lowest revision rate at mid-term follow-up; hemiarthroplasty resurfacing had a higher revision rate after one year (HR 2.51) and stemmed metallic-head hemiarthroplasty across the whole period (HR 2.69). Glenoid erosion drove revisions of resurfacing; instability drove revisions of reverse arthroplasty.
Khoriati AA, et al. — Survivorship of shoulder arthroplasty in young patients with osteoarthritis: an analysis of the Australian Orthopaedic Association National Joint Replacement Registry.. J Shoulder Elbow Surg, 2023. DOI: 10.1016/j.jse.2023.03.024.
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At 10 years, arthroscopic subacromial decompression offered NO benefit over placebo surgery for subacromial pain syndrome: the mean difference in VAS pain was -1.5 points (95% CI -8.6 to 5.6) at rest and -3.2 points (-13.0 to 6.5) on arm activity, against a minimally important difference of 15. It also showed no benefit over exercise therapy.
Kanto K, et al. — Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial.. BMJ, 2025. DOI: 10.1136/bmj-2025-086201.
What can I ask at a shoulder visit?
Bring old images, your medicine list and the movement you want back. The visit can cover your exam, home care and clinic choices. You'll hear when another kind of care makes more sense.
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