Total shoulder replacement is not nearly as common as a total hip or knee replacement, but is just as efficient in relieving joint pain.
A total shoulder replacement, also known as a total shoulder arthroplasty, may be necessary when the pain and function of your shoulder is no longer allowing you to have a great quality of life and non-surgical or less invasive surgical options are not able to help you.
Read on to learn more about different shoulder conditions and injuries as well as what to expect with shoulder replacement surgery.
Common shoulder conditions and injuries
There are several conditions and shoulder pain causes that may contribute to the eventual need for shoulder replacement surgery.
Some of those common conditions and injuries include:
Osteoarthritis is a type of shoulder arthritis. This degenerative joint disease is age-related and usually occurs in people 50 years and older; however, younger people can also be affected by osteoarthritis. The cartilage that cushions your shoulder bones softens and wears away.
This causes the bones to rub against one another, which makes the shoulder joint painful and stiff.
The synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation damages the cartilage and eventually causes cartilage loss, pain and stiffness in the shoulder.
Rheumatoid arthritis is the most common form of a group of disorders referred to as inflammatory arthritis.
This can follow a serious shoulder injury or fracture. The cartilage may become damaged and lead to shoulder pain and stiffness over time, and create the need for shoulder replacement.
Rotator cuff tear arthropathy
A large, long-standing rotator cuff tear can develop into rotator cuff tear arthropathy, which can lead to arthritis and destruction of the joint cartilage.
Avascular necrosis, or osteonecrosis, is a painful condition that occurs when the blood supply to the bone is disrupted. This can ultimately cause destruction of the shoulder joint and lead to arthritis.
Steroid use, deep sea diving, severe fracture of the shoulder, sickle cell disease and heavy alcohol use are risk factors for osteonecrosis.
Severe shoulder fractures
When the head of the upper arm bone is shattered, it can be difficult for a physician to put the pieces of the bone back in place. This is when a shoulder replacement may be necessary.
Symptoms associated with shoulder conditions
- Loss of motion/weakness of the shoulder
- Severe shoulder pain that interferes with everyday activities, from bathing to simple house chores
- Moderate to severe shoulder pain at night
To determine if you need a total shoulder replacement, your physician will ask you for a complete medical history, have you describe your symptoms and conduct a physical examination.
Types of shoulder replacement treatments
There are different types of shoulder replacement procedures. Your physician will evaluate your specific situation and determine the best replacement for you.
In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis.
The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket. Here are some common types of shoulder replacement surgery.
Total shoulder arthroplasty
Involves replacing the arthritic joint surface with a highly polished metal ball attached to a stem and a plastic socket.
You will be fitted to ensure the metal ball works for your shoulder. Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are good candidates for this procedure.
Reverse shoulder replacement
In a reverse shoulder replacement procedure, the socket and metal ball are switched so the metal ball is attached to the shoulder bone and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the rotator cuff to lift the arm.
Patients with completely torn rotator cuffs with severe arm weakness or have severe arthritis and a rotator cuff tear are good candidates for this surgery. It may also be necessary for patients who had a previous shoulder replacement fail.
The head of the humerus is replaced with a metal ball and stem, similar to a traditional shoulder replacement; however, no socket is used. Patients with a severely fractured humeral head but normal socket may undergo this type of surgery.
Additionally, arthritis that only involves the head of the humerus, shoulders with severely weakened bone in the glenoid and some shoulders with severely torn rotator cuff tendons and arthritis may also undergo this surgery.
Involves replacing just the joint surface of the humeral head with a cap-like prosthesis without a stem.
Generally younger patients with an intact cartilage surface of the glenoid, no fresh fracture of the humeral neck or head and a desire to preserve humeral bone may undergo this surgery.
Recovering from shoulder replacement surgery
Most shoulder replacement surgeries require a one or two night stay in the hospital. Physical therapy will start right away but it will not be too intense.
Primarily, a physical therapist will move your arm with you to keep your shoulder loose as it heals. The physical therapist will also show you simple exercises you can do once you leave the hospital.
Total recovery after surgery can take several months. However, you should be able to get back to your daily activities in a few weeks.
Find out what’s really causing your shoulder pain
If your shoulder pain causes you to miss out on normal day-to-day activities, we can help. Request an appointment online or call OrthoIndy at 317.802.2000 to book an appointment with one of our shoulder specialists.
If your shoulder injury or condition is recent, you can walk right into one of our OrthoIndy Urgent Care locations for immediate care. For rehabilitation and physical therapy, no referral is needed to see one of our physical therapists.