Another shoulder replacement?

I'll start this post by apologising, there are a lot of people on here in a worse situation than I am and I'm not entirely sure why I'm posting, perhaps just to vent.

A little background:

• I dislocated my shoulder when I was a child which was successfully relocated without any noticeable complications.
• In my mid-teens I separated the same shoulder (right) playing rugby which eventually resulted in a Subacromial Decompression when I was 19.
• When I was 29 I had a further injury, which I don't believe was properly diagnosed. Following scans I was given 2 rounds of steroid injections and eventually surgery involving; debridement, glenoid microfracturing and a biceps tenodesis.
• When this led to ongoing pain and restricted ROM my surgeon said "There's nothing more I can do for you" and left me high and dry.
• After research and talking to a lot of people, the same surgeon's name kept coming up and I was fortunate that he was local and was transferred under his care.
• I believe the care I've been getting has been absolutely first class, I sometimes wonder though whether I'm blinded because of the experience of having a surgeon wash his hands of me though.
• Since I transferred to the new specialist I've had several rounds of steroid and hyaluronic acid injections, which helped for a while. I then had a contracture release, which again, helped for a while.
• 4 years ago I had a Total Shoulder Replacement, the procedure didn't quite go to plan as it was discovered I had Primary Glenoid Dysplasia although he was able to complete the procedure.
• After about 18 months I started experiencing significant pain and eventually decided to have a revision. It was discovered that owing to complications with Dysplasia, amongst other things, I had severe metalosis which had significantly damaged the bone surrounding the joint. He was only able to complete a hemiarthroplasty given the damage.

I'm now 2 years on from that and have had a mixed time of it since. The positives are that there's been extensive remodelling, which was one of the intended outcomes of the procedure. The long-term prognosis following that op is that I would need a third replacement of some description, and the remodelling makes that much more likely to be successful.

I had hoped I might get 5+ years out of this one, however, I'm down to about 20-25% ROM through most planes, I can't get passed neutral in external rotation and probably 20 deg or so in anterior elevation.

I've spent much of the last 5 years or so on prescription pain killers until around Christmas where I decided after years of outright refusal to try CBD. I'm pleased and surprised to say it was a revelation, I was pain killer free within weeks and eventually got back to being able to exercise. The way I would describe it is that it's raised my pain threshold, rather than reduced the pain itself. However following the months of lockdown, changes to my working situation, things have deteriorated further and it leaves me with few options but to go back under the knife.

In the run up to each procedure I become very nerdy on the situation to try and make sure I'm doing the right thing, with the right surgeon for the right outcome.

I'm now 36, have two young kids, I've had to stop all the sports that I've enjoyed doing, needless to say, my wife's fed up of....shouldering (sorry)... the burden when I've spent months unable to help at home.

I do realise everyone's different, I once asked my current surgeon how many cases he'd seen like mine, he replied that he'd done around 900 complex replacements and revisions and had 4 like mine, including me and only 1 other of those was under 60.

I guess I'm wondering where it'll all end, whether anyone with a vaguely similar case has any insights, recommendations.

Apologies for the essay!

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