Reversing Course

Correct severe shoulder damage.

Never one to waste a lot of time just sitting around, Diane Costa spent the majority of her working years on her feet, first as a waitress and a bar maid, then as a wallpaper hanger and a furniture refinisher and finally as a cake decorator.

Diane Costa had reverse total shoulder replacement surgery and is glad she did.

Diane has regained full range of motion in her left shoulder.

Surprisingly, it was her shoulders that took the brunt of the abuse from that odd array of jobs. As a result of the repetitive nature of the wallpaper hanging, and refinishing, Diane had rotator cuff surgery on both shoulders, the right one in 2005, the left one in 2006.

More trouble developed for Diane a few years later when she stumbled over a poorly fitting drain hole cover in the kitchen where she was decorating cakes and fell, severely injuring her knee, back and left shoulder.

The fall resulted in Diane undergoing a meniscus repair on her knee while receiving radiofrequency treatments on her back. Her shoulder injury was not treated, however, because her insurance company, citing her previous injury, refused to cover the cost.

“After that, I just went to hell in a handbasket,” says Diane, who eventually developed arthritis in both shoulders and lost so much strength in her left shoulder that she could no longer perform even the simplest of household tasks.

“I couldn’t strip the sheets off the bed to wash them or make the bed again when the sheets were cleaned,” she says. “I couldn’t pick up a frying pan, so I had trouble cooking.  And when I drove, I had to keep my left hand at the bottom of the wheel because I couldn’t lift it up to the ten and two position.

“The worst thing of all, though, was that I had a lot of trouble lifting up my husband, who had recently undergone hip and knee surgery and then had a stroke and needed my help getting up out of chairs and getting dressed.”

Diane and her husband were living in North Carolina at the time of her husband’s stroke. Before long, their daughter moved them to Florida, where one of her first tasks was to arrange for her father to undergo rehabilitation therapy at Advanced Orthopedic Center.

It was during one of those therapy sessions that Diane learned that one of the doctors at Advanced Orthopedic Center – Robert P. Stchur, MD – could repair her ailing shoulder by performing what is known as reverse total shoulder replacement surgery.

Transfer of Power

Originally designed in Europe in the 1980s, the reverse total shoulder replacement procedure was approved by the Food and Drug Administration for use in the United States in 2003 as an alternative to traditional shoulder replacement surgery.

It is considered a better option for anyone who has suffered a large tear of a rotator cuff or anyone suffering from severe arthritis in the shoulder because it forces the shoulder to use different muscles than it normally does to lift the arm.

In a healthy shoulder, the muscles and tendons in the rotator cuff work together to keep the ball of the upper arm bone, which is the humerus, in the shoulder socket. They also work to power the process of raising and rotating the arm.

The reverse total shoulder replacement procedure transfers the task of powering the arm to the deltoid muscle through the use of a device that places a metallic ball where the socket was and a socket where the ball was.

Diane Costa had reverse total shoulder replacement surgery and is glad she did.

The DELTA XTEND™  Reverse Shoulder
System is a total semi-
constrained shoulder arthroplasty.

“You’re basically just flipping the joint around,” says Dr. Stchur (pronounced Sure). “Especially with older patients, it’s the best way to go because the failure rates of traditional surgery are much higher in patients with big tears and poor-quality tissue.

“And I’ve seen it happen where someone has gone through a big repair and months of rehabilitation and then they tear the shoulder again, and they have to go in and do the reverse anyway. That’s why we’re favoring the reverse more and more.”

When he first examined Diane in October 2018, Dr. Stchur discovered that her left shoulder was completely devoid of cartilage and that she was indeed a good candidate for the reverse total shoulder replacement surgery.

That surgery took place a few weeks later, and within six weeks of having the surgery, Diane was using her shoulder normally again. Had Diane opted for traditional surgery or even another rotator cuff repair, her downtime would have been three to six months.

“That’s one of the great advantages of this surgery,” Dr. Stchur says. “The recovery time is shockingly fast because we’re not repairing anything. We’re placing metal and plastic components into the shoulder that stick to your bones immediately.”

Patients are often encouraged to begin using their new shoulder immediately as part of their rehabilitation. Diane is among those who began using their shoulders again within a matter of days. She is now back to using it normally.

“For so long, it seemed like I was the one who had the stroke, because I couldn’t use that arm at all,” Diane says. “But now, I can do anything.

“The last time I went to see Dr. Stchur, he had to laugh because he reached out to shake my hand, and I said, No, no, no, give me a high-five instead. I’m telling you, having that reverse shoulder surgery was the best thing I ever did.

“I’m so happy with it that I’m going to have it done on my other shoulder, too, and I’ll have Dr. Stchur do it because he is a fantastic doctor. He has all the qualities you want and expect in a great doctor, and I highly recommend him.”

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