i had replacement 12/6, and i agree this was the worst part. i asked my dr and he supplied a different sling that goes around the shoulder. much more comfortable

@CarlaForth Perhaps you should get a second opinion? The usual course, is you are given a nerve block, prior to surgery, that numbs the shoulder for approximately 24-48 hrs. You’re given opiates, an NSAID, for 1-2 wks, plus you’ll be in a sling, that has an abductor pillow attached. You’re fairly immobilized for the first couple of weeks. They have you shower at home, with an anti-bacterial soap at home, and possibly, an antibacterial ointment, that you put in your nostrils, 5 days prior to surgery. They also do a surgical scrub, of the area to be incised to replace your joint. I felt no pain, until 30 hrs. After my replacement. I was awake, pain-free, and able to ride home about an hour after surgery. After the first week, I didn’t require pain medication, just an NSAID, Celebrex, for the second week. It really isn’t a painful ordeal, compared to several other surgeries, I have experienced. Good Luck, with find the right Dr.!

I'm having mine in 30 days . I'm thinking of everything positive. I'm sorry for all of you that have poor results.

Just had mine done 12/16 you will be fine with oxycodone 5mg and make sure you ice every hour for couple weeks it makes all the difference in your healing...good luck

@17moonlite it is certainly possible, the actual sling part over the neck is the easiest, the only challenging part is the "around the waist" section. I usually recommend getting a good routine down and practicing BEFORE the procedure.

Jan, thank you so much, am just starting down the road having tests and what not. I’m 73 and very worried about it being over for me.

Good to hear this. I'm 72yrs and I've had left and right knees and hips done. I am expecting pain but controllable. I realize time is expected and I want to be able to go to the bathroom, shower, and change my clothing with limited help.😊

I’m almost 70 and had it done 5 week’s ago and it’s the smartest thing I have ever done.

how did it go?

@foreveranuj with this injection there is not any considerable numbness that the patient experiences. The main goal is to deliver steroid medication which works by reducing inflammation for longer term (weeks or months) rather than just a few hours. And yes, most insurances cover cost of the injections.

@@RaleighUpperExMD Much appreciated, thank you!

And thank you.

Great question. I use this injection whenever possible in patients where usually I would use a subacromial injection: rotator cuff tears being treated non operatively, bursitis and impingement findings on physical exam, and even rotator cuff arthropathy. There is a very high-quality level-1 study that shows these suprascapular injections out-perform subacromial injections in terms of outcomes and pain relief for patients. Sometimes I still do subacromial injections, for example if the ultrasound is tied up somewhere else OR if the patient already tried the suprascapular injection and it didn't seem to help much. Also some patients had previous subacromial injections that worked very well, so we decide to do the same injection again. For straightforward glenohumeral arthritis without a rotator cuff tear, I do not generally use these injections because I feel the main pain generator is the entire joint capsule, which is only PARTIALLY innervated by the suprascapular nerve. For those patients, I use ultrasound-guided intra-articular injections. You are correct, the suprascapular artery does pass just dorsal to the ligament, often you can see it pulsing on the ultrasound. While I do not worry about damaging it (have you ever tried to stick a needle in a very LARGE artery? Not easy, and even harder for a smaller artery like the suprascapular artery) I usually slightly draw back on the syringe before I give the medication. I have never encountered a complication with this.

Could you link that study please, I would like to look at it, could not find it myself. Thank you! I'd like to start incorporating this into my practice@@RaleighUpperExMD

@@cak3ofd3ath pubmed.ncbi.nlm.nih.gov/30651194/

@crystaldunn3541: Thank you for your comment! However wearing gloves will do nothing to change my infection rate with this and every other in-office injection I perform, which is 0.00000%! That practice WILL do a great job putting thousands upon thousands of plastic gloves into our landfills every year. For more info: www.osha.gov/laws-regs/standardinterpretations/1992-09-01-0

Hello, yes. Make sure probe is parallel to scapular spine, just dorsal to it. Make sure depth is set to 4 or 4.5, even deeper depending on the patient. If you are not seeing any bone signal, likely the depth isn't set deep enough. With probe parallel to the spine, scan laterally and you will se a "ski slope" dip/depression in the bone signal: this is the notch. If you go too far lateral, you will hit acromion process. Too far medial, no ski slope.

@@RaleighUpperExMD thank you so much

@@RaleighUpperExMD Did you mean ventral to scapular spine? Great video, thanks.

@@LesPaul4684 I think the terminology that would be better would be "cephalad" to the scapular spine, above, towards the head, over the supraspinatus fossa instead of the the infraspinatus fossa.

Great questions. In terms of pullout strength of the anchor or fixation device in kg, that really depends on the particular device. For my subpectoral tenodesis patients, I use a device different from what is in this video called a cortical endobutton which has an in-lab pullout strength of approximately 25kg. This doesn't sound like much, but is certainly more than enough for the forces exerted through the long head of the biceps. To answer your second question, a well-placed subpectoral biceps tenodesis can certainly withstand simple active forearm rotation without fear of rupture. While you need to consult your surgeon about your case, in my patients I allow them to move their elbow and rotate their forearm as tolerated for "activities of daily living" immediately after surgery, and at 6 weeks after surgery they can begin some gentle, low-resistance and low-frequency strengthening of the biceps and gradually increase resistance over the following month.

Great Video !!!! As a Surgeon do you prefer the high in the groove Tenodesis or Low in the groove. Tenodesis for your patients??? Once that tendon is fully healed into the bone is that where the blood supply now feeds the Long Head tendon ??

​@RaleighUpperExMD Thanks for answering my question Dr. I only returned back to this video now and see that you responded so thank you. I have a question around deep tissue massage. At around or just under 6 months from surgery, if a therapist was to do deep tissue massage into the site where a subpectoral biceps tenodesis is located I.e. pressing their fingers deep into the insertion point where the tendon and anchor are located. Would or could this deep massage and pressing deep with fingers damage the tendon, or damage/compromise the repair itself? I understand that my surgeon used an Arthrex Fibertak biceps all suture anchor.