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Should You Get Shoulder Surgery? A Surgeon Weighs In…

POSTED ON IN Shoulder BY Chris Centeno

shoulder surgery alternative

If you read this blog, you know that I often write about what I experience on a day-to-day basis. After all, it’s hard to do this six days a week if you’re not passionate about what you write about. This morning I’d like to share my experiences yesterday with an orthopedic shoulder surgeon who was very frustrated with our approach toward shoulder surgery. I suspect that he had a patient show up with one of my blogs in hand that discussed how the research behind shoulder surgery is not that favorable. So let’s jump into that discussion with an eye turned toward the bright future of interventional orthopedics rather than to the dim past of invasive orthopedic surgery.

A Frustrated Surgeon

Yesterday, my staff alerted me to a local orthopedic shoulder surgeon who had left some unkind comments on our chat system. I immediately recognized the name from a time in my practice when my approach was to try a steroid shot and physical therapy and when that plan didn’t work, I would send these patients to this surgeon. Fast forward a decade and a half and it’s rare that I send patients for shoulder surgery. Why? Interventional orthopedics was developed mostly by our clinic but is now spreading across the country outward from Colorado and other locations.

What is interventional orthopedics in comparison to what I used to do? Watch my video below to both see how much more complex interventional orthopedics is than simple shoulder injections as well as why your shoulder surgeon likely has no idea what it is or how to accomplish shoulder healing without surgery:

Do You Need Shoulder Surgery?

First, let’s put aside the idea that if physical therapy and steroid shots fail, you need shoulder surgery. Let’s instead start with the idea that nobody needs shoulder surgery for pain unless we can prove that it works. So let’s see what’s been published:

So what can we say about all of this research that questions the effectiveness of very common shoulder surgeries? That the research support for these invasive procedures for many indications just isn’t robust enough to support the risks of the procedure.

Surgeons Will React to This News…

Let’s face it, if you’ve spent your whole career learning and perfecting shoulder surgery techniques, the last thing you want to hear is that common shoulder surgeries have large studies showing they don’t work. However, make no mistake, that’s what’s happening year after year as more and more high-level research questions whether orthopedic surgeries are effective. Hence, surgeons are bound to react to this news, which is what we saw this week. We’ve even seen surgeons bombing our Facebook page or LinkedIn posts when we share high-level research that questions whether these invasive procedures work.

Is There a Better Way?

We’re just completing our own randomized controlled trial of using advanced interventional orthopedics to heal or reduce pain in rotator cuff tears without surgery. This stem cell study has produced promising results so far in helping patients avoid the knife. Hopefully, this will be done this year and we can publish these results. Given what we’re seeing, I would estimate that by 2030–2040, 50–70% of elective orthopedic shoulder surgery will be relegated to the dustbin of medical history. In addition, what can be done without surgery by precisely placing healing agents (like stem cells, platelets, recombinant proteins, and the like) exactly into the damaged tissue using imaging guidance will expand. Also, we’ll see new tools that allow image-guided injections to compete head-to-head with more and more orthopedic surgeries. To see what we do right now to help patients avoid shoulder surgery, watch my video below that features Dr. Schultz at our Colorado HQ:

The upshot? It’s not surprising that we’re seeing shoulder surgeons react to new technology that will likely replace much of what they do. However, as a patient, please be aware that you’re in the middle of a major paradigm shift. So don’t get caught up in being forced into old tech when new tech is here or just around the corner.

    *DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.
    Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

    comments

    Mariette says

    I am 77-yrs old F with grinding and some discomfort in my Rt shoulder. I have been told I need a shoulder replacement which I have now cancelled. I have never had to take any pain medication for the discomfort and am more concerned abt thrombosis and the long rehab post-op than the fact of bone grinding on bone. But I never see you mention stem cells for this condiition awaiting in the future.

    replies

    Regenexx Team says

    Hi Mariette,
    Unfortunately, shoulder replacement is the least successful of all the joint replacements, and you are wise to seek alternatives to avoid the risks of the surgery. We treat shoulder arthritis regularly. Please see: https://www.regenexx.com/conditions-treated/shoulder/shoulder-osteoarthritis/ and https://www.regenexx.com/blog/can-treat-severe-shoulder-arthritis-injection/ and https://www.regenexx.com/blog/severe-shoulder-arthritis-stem-cell-update-im-blown-away/ If you'd like to see if you would be a Candidate, please submit the Candidate form, or give us a call at 855 622 7838 and we can assist with the process.

    replies

    Rich C says

    I have rt shoulder bone on bone with no cartilage for at least 5 years, avid swimmer 3x/week for 1 mile, age 62 male. The Boston orthodic surgeons want to do shoulder joint replacement, but I keep holding them off. What are my alternatives? Who can I see in the Boston area?

    replies

    Regenexx Team says

    Hi Rich,
    Unfortunately, we don't have a Regenexx Clinic in the Boston area yet, but we do have several approximately equidistant from you. Shoulder replacement is a great one to avoid if possible. To see if you would be a Candidate, please submit the candidate form here: www.regenexx.com and we can see what the best location for you would be. Please see: https://www.regenexx.com/blog/watch-advanced-image-guided-injection-shoulder-step-procedure-suite-dr-schultz/ and https://www.regenexx.com/conditions-treated/shoulder/shoulder-osteoarthritis/

    replies

    David Barker says

    I am scheduled for right shoulder replacement February 12. I have osteoarthritis bone on bone with 2 cysts in the socket. Can be very painful. I worn my joints out in the military because I was the fitness trainer for our unit. The VA denied my claim even after all the doctors that I have seen said it was the result of my service. I retired from the military in 1998. I already had my left shoulder replaced 4 years ago which is doing great, but the recovery was terrible. I would like to avoid the surgery if at all possible. Please advise.

    replies

    Regenexx Team says

    Hi David,
    Do you have a current MRI of that shoulder?

    replies

    Jacki HOLLAND says

    I have Ehleurs Danloss and experience calcium absorption difficulty which caused each THP to have revisions. Now, my pain doctor is saying that I do need shoulder replacement. I do ot want it and prefer Vicodin and a retired life style ; I do still ride my horses a bit but do not show. My shoulder joint are bone on bone and are eroding. They "catch" and cause extreme pain. The surgeon says I may loose the use of my arms with surgery and it would be six months after replacement to know and each shoulder would be different. I see y life destroyed by this. Ideas? I am receiving steroid shots which help but still need Vicodin ( back is a mess too)

    replies

    Regenexx Team says

    Hi Jacki,
    Which type of EDS?

    replies

    Jacki HOLLAND says

    I was diagnosed with type 2 which seems to be higher with age. Calcium to set the hip replacement was a problem so was revised with titanium + CA and seem ok except for cut muscle to put in implant that goes to the knee. Chemo has also affected EDS.

    replies

    Regenexx Team says

    Hi Jacki,
    Joint replacement is irreversible, and shoulder replacement is one of the least successful. Please see: https://www.regenexx.com/blog/shoulder-replacement-side-effects-are-far-worse-than-we-thought/ We always recommend trying all less invasive procedures first, that's even more important in EDS. If you'd like to see if we can help, we'd need more information. To do that, please use the "Get Started" form here: https://www.regenexx.com/conditions-treated/shoulder/

    replies

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    About the Author

    Chris Centeno

    Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…

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