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I had a total shoulder replacement about nine months ago. I'm not really very happy with the results. My wife says, "What did you expect? It's just a fake joint, not the real thing." I guess I did expect more. Am I out of line? What do other people say?

Whether they know it or not, every patient goes into any surgery with certain expectations. In the case of joint replacements, it's typical to expect relief from pain and improved motion. Those two outcomes usually translate into better function, too. Expectations are often individual based on age, general health, and preoperative symptoms (pain, fatigue, inability to take care of self, depression). Sometimes patients are influenced by what the surgeon tells them about what to expect. According to a recent study from the Hospital for Special Surgery in New York City, younger adults expect more after total shoulder replacement when compared with older adults (65 and older). People wo have poorer health before surgery also tend to expect more afterwards. Anyone suffering pain (day or night) definitely goes into surgery expecting to be pain free afterwards. It might be helpful if you could identify what is not satisfactory for you. Include in your list your symptoms and what it is you want to be able to do that you are unable to do at this point. Take your list to the surgeon and discuss what is reasonable nine months post-op. It may be possible that a short course of physical therapy would be helpful in tipping the scale from "not very satisfied" to "very satisfied" with results. If your expectations are just too high, then that knowledge may help you reorder your thinking by lowering your expectations. That sounds simple and easy -- we know it's not. But sometimes that is still the best place to start.

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