Total Shoulder Replacement
Total Shoulder Replacement in Cincinnati
Total joint replacements are often required due to damage or deterioration. Fortunately, the expert surgeons and staff at Beacon Orthopaedics and Sports Medicine are able to perform outpatient shoulder replacements in many cases.
Content List
- What is Shoulder Replacement Surgery?
- Why is Shoulder Replacement Surgery Performed?
- What is Shoulder Arthritis?
- How is Shoulder Arthritis Diagnosed?
- Preparing for Shoulder Replacement
- The Shoulder Replacement Procedure
- Recovery After Total Shoulder Replacement
- How Long Will My Shoulder Replacement Last?
- What are the Risks of Surgery for Outpatient Shoulder Replacements?
- What Are My Restrictions After a Total Shoulder Replacement?
What is Shoulder Replacement Surgery?
In total shoulder replacement, the damaged surfaces of the humeral head and glenoid (the “ball” and “socket”) are resurfaced with metal and plastic implants. The humeral head is replaced with a metal component and the glenoid socket is replaced with a polyethylene component that is glued in with bone cement.
When both sides of the shoulder are replaced, it is called a total shoulder replacement. When only the humeral head is replaced, it is called a partial shoulder replacement, or shoulder hemiarthroplasty.
Primary shoulder replacement is performed on patients who have osteoarthritis of the shoulder. For patients who suffer from both osteoarthritis and rotator cuff insufficiency, a reverse shoulder replacement is performed.
Why is Shoulder Replacement Surgery Performed?
Shoulder replacement surgery should be performed to alleviate pain and improve function. It is an excellent option for patients that have failed other conservative measures such as physical therapy and anti-inflammatory medication. Conditions that commonly lead to shoulder replacement surgery include:
- Arthritis, especially osteoarthritis
- Rotator cuff injuries
- Fractures
- Osteonecrosis1
What is Shoulder Arthritis?
Arthritis is a common disease that affects the shoulder, causing joint pain, stiffness and swelling, and is a leading cause of total shoulder replacement. When a person gets arthritis, they lose cartilage or the cushion in the joint. Cartilage allows the joint to glide easily during motion. When enough cartilage wear occurs, bone on bone rubbing begins, which can be very painful. In addition, the joint becomes inflamed and there is usually a restriction of motion.
How is Shoulder Arthritis Diagnosed?
Many patients will complain of a deep ache that can radiate down the arm. The pain usually gets worse with movement or activity. With time, there may even be pain at rest and eventually, patients will awaken at night with shoulder pain. Patients often complain of grinding and difficulty with motion. A physician will diagnose arthritis through a thorough physical exam and taking the proper x-rays.
Preparing for Shoulder Replacement
Prior to shoulder replacement surgery, patients undergo a CT scan. The images produced during this scan are uploaded into a 3D planning system that allows the orthopedic surgeon to create customized, patient-specific guides for the shoulder implant.
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The Shoulder Replacement Procedure
Total shoulder replacement is performed under general anesthesia. An incision is made from the top front of the shoulder along the deltoid muscle, and the surgeon exposes the shoulder joint. The humeral head, or top of the upper arm bone, is dislocated from the socket and the humeral head is removed. Once the humeral stem is prepared for the artificial shoulder, the artificial socket is placed. A prosthetic shoulder ball is then attached to the top of the socket. Once the surgeon is satisfied with the fit and function of the artificial shoulder joint, the incision is closed.2
Recovery After Total Shoulder Replacement
Physical therapists will begin moving the shoulder on the first postoperative day and patients will wear a sling, typically for the first 4-6 weeks. While recovery time will vary among patients and severity of conditions, precautions should be implemented for the first 6-12 weeks postoperatively.
How Long Will My Shoulder Replacement Last?
Anytime implants are used to replace your normal anatomy, it is expected that they will wear with time. The survivorship of a shoulder replacement is up to 93% at 10 years and 87% at 15 years.3 At one year from the time of surgery, 98.4% of patients reported an improvement in shoulder pain, function, and satisfaction.4
What Are My Restrictions After a Total Shoulder Replacement?
Most activities can be resumed after a shoulder replacement. A person usually resumes activities such as swimming, golf and tennis by six months after surgery. Activities that involve major impact (such as contact sports or those where falls are frequent) or heavy loads (such as lifting heavy weights) should be avoided since these may increase the chance of rotator cuff tears, hardware loosening, increased wear and/or fracture.
What are the Risks of Surgery for Shoulder Replacements?
Complications are rare, but they are also real and do happen. Some of the more common complications include infection, stiffness, instability, component failure, fractures around the prosthesis and failure to get complete pain relief. Fortunately, the benefits of shoulder replacement far outweigh the risks.
Contact Beacon Orthopaedics
If you are suffering from shoulder pain and problems that have not responded adequately to physical therapy and other non-invasive treatments, total shoulder replacement may be the solution for you. To learn more about this procedure and your candidacy, contact Beacon Orthopaedics to schedule a consultation with a shoulder specialist.