Shoulder Replacement

Shoulder replacement surgery, also known as shoulder arthroplasty, is a durable and reliable procedure designed to replace the damaged parts of the shoulder joint with artificial components made of plastic and metal. The goal is to alleviate pain, improve function, and restore the joint’s mobility. Shoulder replacement is considered for individuals suffering from severe shoulder pain and dysfunction that significantly affects their daily activities and quality of life.

Common indications include:

• Osteoarthritis: A degenerative joint disease characterized by the breakdown of cartilage that cushions the ends of the bones, leading to joint pain and stiffness.
• Rheumatoid Arthritis: An autoimmune disease that causes inflammation of the joint lining, resulting in pain, swelling, and eventual joint damage.
• Post-traumatic Arthritis: A condition that develops after a traumatic shoulder injury, such as a fracture or dislocation.
• Rotator Cuff Arthropathy: The rotator cuff is a group of muscles and tendons that attach to the humerus (arm bone). A long-standing, large rotator cuff tear can lead to a specific type of shoulder arthritis called rotator cuff arthropathy.
• Avascular Necrosis (Osteonecrosis): A condition in which blood flow to the bone is reduced, leading to bone death and the shoulder joint’s collapse.
• Shoulder Fractures: This includes proximal humerus fractures, especially those that cannot be adequately repaired and require partial or total shoulder replacement.
• A failed previous rotator cuff repair or shoulder replacement that has not alleviated the patient’s symptoms may result in the need for a shoulder replacement.

Shoulder replacement surgery is designed to treat severe pain and dysfunction caused by the above conditions. The primary goals are pain relief, restoration of function, and improvement in quality of life. It is considered when nonsurgical treatments, such as medications, physical therapy, and less invasive surgical procedures, have not provided adequate relief.

There are three main types of shoulder replacement surgeries, each designed to address specific conditions and patient needs:

1. Anatomic Total Shoulder Arthroplasty/Replacement: Where both the ball (humeral head) and the socket (glenoid) components of the shoulder joint are replaced with artificial parts. The patient must have intact or repairable rotator cuff tendons. This is typically used for patients with shoulder arthritis.
2. Shoulder Hemiarthroplasty (partial shoulder replacement): Only the ball (humeral head) is replaced. This option might be considered when the socket is still in good condition or specific patient circumstances.
3. Reverse Total Shoulder Arthroplasty/Replacement: In this type of replacement, the positions of the ball and socket are reversed, with a ball component attached to the shoulder blade and a socket component attached to the upper arm bone. This design is used for patients with torn rotator cuff tendons or severe bone loss.

The specific type of shoulder replacement surgery chosen depends on multiple factors, including the patient’s age, activity level, shoulder joint condition, and the presence of other medical conditions.

Effective rehabilitation is essential for maximizing the outcomes after shoulder replacement surgery. It requires a committed effort from the patient, guided by a team of healthcare professionals, including their surgeon and physical therapist, to achieve the best possible recovery and return to activities.

Studies report that return to sport (RTS) after shoulder arthroplasty is high in patients aged 65 and over. Total and reverse total shoulder arthroplasty are very successful operations, with 90% of implants free of complications 10 years after surgery. They are safe and effective in relieving pain and restoring function so you can return to the life you love and the sports that make life worth living.

With advancements in the technology, techniques, and biomechanical understanding of shoulder arthroplasty, most patients who undergo a shoulder arthroplasty procedure can expect to resume their normal activities approximately six months to 1 year after their shoulder replacement.