Total Shoulder Replacement
Hope for Those Suffering from Shoulder Pain
Many people know a friend or relative who has had a hip or knee replacement done to treat arthritis. These surgeries are very successful and get people back to living active, pain-free lives. While not as common as hip or knee replacement, the same type of surgery can be done for painful shoulder arthritis with similarly excellent results.
The shoulder is a non-weight-bearing joint. Therefore, it is much less likely to become arthritic than the hip or the knee. In fact, there are only about 53,000 shoulder replacements compared to 900,000 hip or knee replacements done each year in the United States. Shoulder replacement was first done more than 50 years ago. It was initially used to treat severe fractures of the shoulder that could not be repaired.
Over the years, the implants and techniques have evolved so that, today, shoulder replacement is used to repair a wide range of shoulder problems. Shoulder replacement can effectively treat degenerative arthritis, rheumatoid arthritis, osteonecrosis (a condition in which the bone in the shoulder dies) and arthritis from chronic, nonrepairable rotator cuff tears.
The shoulder joint is a ball-and-socket joint and has the widest range of motion of any joint in the body. We often take this wide range of motion for granted. It allows us to place our hands over our head to wash our hair, to place our hands behind our back, to tuck in our shirt and to shake someone’s hand.
Arthritis of the shoulder causes pain and compromises the normal range of motion, which can lead to difficulty performing these simple, normal daily activities. Shoulder arthritis causes a deep aching pain in the shoulder region. The pain may be felt in the front, side or back of the shoulder. It is usually aggravated by activity and improved with rest. Often a sense of grinding or popping can occur with the motion of the shoulder. Patients will often have pain at night, and sleeping can be difficult. The diagnosis is usually made by listening to the patient’s history and performing a physical exam. X-rays will confirm the diagnosis. MRI is rarely needed.
What is a Total Shoulder Replacement?
If you’re experiencing severe shoulder pain and loss of motion or weakness in your shoulder, total shoulder replacement surgery may be recommended. During a total shoulder replacement surgery, your shoulder doctor will replace the damaged bone and cartilage from your shoulder with a new ball-and-socket joint made of metal and plastic.
The new, artificial components fit into the top of your arm bone and your shoulder blade, restoring full function of your shoulder joint. During a total shoulder replacement surgery, your shoulder doctor will first remove the ball from the top of your arm bone, replacing it with a metal implant. Then, your doctor will clean the socket of your joint, removing the damaged portions and replacing your socket with a plastic component.
Most patients are pleased with their outcome after 6–12 weeks, but can take 12-months for a full recovery.
When is it Time for Total Shoulder Replacement?
Patients who have bone-on-bone arthritis of the shoulder and are no longer responding to conservative measures become joint replacement surgery candidates. Conservative measures can include anti-inflammatories, activity modification, arthroscopic surgery, and simple measures like heat or icing. When these measures no longer help, the impact on your activity increases and your quality of life goes down. That is when you become a good candidate for joint replacement.
Who is a Candidate for Shoulder Replacement?
The patients that do the best with joint replacement surgery have three things in common. First, they have bone-on-bone arthritis. Bone-on-bone arthritis is painful because the nerves in the bone are exposed and grate against other. Secondly, they have a disability in their life because of the arthritic joint. They have an increasingly difficult time doing activities that are important, like working, activities of daily living, exercising, or being independent in the community. Lastly, we need confirmation that arthritis in the shoulder is bad enough for it to be improved with a prosthetic joint. This is confirmed with an X-ray, MRI, or arthroscopy. When these three factors are present, we can expect the absolute best outcome from joint replacement surgery.
How is a Total Shoulder Replacement Performed?
During a total shoulder replacement, the arthritic ends of the bone are cut away and replaced with a combination of metal for the ball and plastic for the socket. Sometimes in younger, very active patients or in certain types of arthritis, only the ball will be replaced. Your shoulder will be exposed through an incision on the front of the shoulder. One of the rotator cuff muscles, the subscapularis, will be detached to enter the joint. After the implants are secured in place, this muscle is repaired back to the bone. Surgery will take about an hour and a half. The components will be pressed into place during surgery and your body will ultimately heal to them.
See a Specialist
To learn more about total shoulder replacement surgery, please request an appointment online, or call 888-660-2663 to schedule a consultation with a Northwest Orthopaedic Specialists specialty-trained shoulder doctor.
Once you have scheduled your appointment with one of our shoulder doctors, please use the link below to obtain our new patient forms and browse through our tips and suggestions on preparing for your appointment.