I've had R A since 1992 and currently take 25 mgs of methotrexate and Enbril injection weekly along with usual anti inflamataries etc. A couple of days ago I fell and caused significant injury to my left shoulder, 3 fractures to my humerus one being across the ball joint leaving this partially dislocated. I am currently in an orthopaedic ward in a lot of pain. Yesterday options for surgery were discussed with me, no surgery being the preferred option of the shoulder consultant. The option of pinning, partial and full shoulder replacement was explained. Due to high risk of infection due to anti tnfs and methotrexate the consultant wasn't keen to operate. He said whatever option I took I would have some loss of movement and likely hood of future pain. Except for full shoulder replacement but this may only last 10 years and I am currently 60. I was given half an hour to consider If wanted surgery that morning. Because of long term RA and drugs I have been treated with he thought by bone would be to soft to pin successfully but wouldn't know this until they opened me up. I think I was subtedly persuaded to go for leaving the shoulder strapped up to heal naturally for 4 weeks followed by physio. I live on my own so would need a care package at home I was also promised a full shoulder joint replacement in the future if if the level of pain or disability was too much. Which would leave me with some restricted movement but no pain. After spending a third night in considerable pain in hospital I don't know if I have made the right decision. I did ask if they would speak to my rheumatologist but they saw little point and thought he would just say the same. I would love to hear from anyone with RA who has been in similar situations and outcomes of shoulder surgery versus leaving alone, for those with RA and significant fractures. Best wishes to all I'm looking forward to replies. Xx
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