Total Shoulder Replacement
Modern advancements in shoulder replacement surgery have resulted in high rates of successful outcomes for patients with shoulder arthritis. Clinical success rates of 93-95% with improvements in pain relief and restoration of shoulder function have been achieved. For a patient with severe osteoarthritis of the shoulder who has failed attempts at conservative treatment, a total shoulder replacement is a remarkable surgical alternative. Following a shoulder replacement, patients are typically able to return to their previous activities with little or no pain and improved overall function. Most patients are able to return to these activities within 3-4 months.
WHAT IS A Total SHOULDER REPLACEMENT?
A total shoulder replacement replaces both the arthritic humeral head (ball) and glenoid (socket) with a prosthetic implant. The humeral head is replaced with a metal ball which is sized to recreate the normal anatomy of the joint surface. A surgical plastic, known as polyethylene, is used to resurface the worn glenoid (socket). This articulation between metal and polyethylene is very similar to the implants used in modern hip and knee replacement. Total shoulder replacement restores the pre-arthritic anatomy to the shoulder, allowing for a smooth surface and relief from the inflammation related pain of arthritis. For total shoulder replacement to function like a normal shoulder, the rotator cuff must be intact without injury or tears. If the rotator cuff is torn or not functioning properly, a reverse shoulder replacement is usually the best option to return function and relieve pain.
WHEN IS total SHOULDER REPLACEMENT USED?
Total shoulder replacement is indicated when conservative measures have failed to provide relief from the pain of shoulder arthritis. Conservative treatments may include non-steroidal anti-inflammatory medications, physical therapy, activity modification, and corticosteroid injections. Surgery is typically reserved for older patients but may be indicated in younger patients who have tried all other options without improvements. Whether to proceed with a total shoulder arthroplasty should be a quality of life decision. If the patient’s quality of life is dramatically affected by shoulder pain and loss of function from arthritis, then a total shoulder arthroplasty should be strongly considered. Patients should be encouraged to identify those surgeons who perform a high volume of shoulder arthroplasty, as these surgeons are best at determining if a shoulder replacement is indicated and may perform the surgery with lower rates of complications.
HOW LONG DOES THE SURGERY TAKE?
The surgery is done using a general anesthetic and typically takes approximately 1-2 hours.
WHAT IS THE RECOVERY PROCESS?
Typically, you will be immobilized in a sling for a period of 6 weeks to allow for healing. During this time, only gentle passive motion of the shoulder is allowed. After 6 weeks, you will begin a progressive therapy program that emphasizes stretching followed by strengthening. Patient are typically able to begin exercise or recreational activities anytime beyond 3 months from the time of surgery.
Learn more about the DJO Surgical implants Dr. Formaini uses for shoulder replacement by clicking the logo:
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