Shoulder Replacement Surgery
Are you undergoing nonsurgical treatments to relieve shoulder pain and stiffness due to arthritis — such as injections, physical therapy, activity modification, and pain medicine? If these treatments are no longer effective, you may want to consider shoulder replacement surgery, also known as shoulder arthroplasty. While not as well known as hip and knee replacement surgery, it is considered a safe and effective procedure to relieve pain and may help you resume everyday activities.
How shoulder replacement surgery works
Your shoulder consists of three bones: the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). The head (ball) of your humerus fits into a shallow socket (glenoid) in your shoulder blade.
In healthy shoulders, the joint surface of the ball and socket are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily. But in arthritic shoulders, this cartilage layer is worn out and no longer lubricated (Figure 1). When the cartilage layer is destroyed, it results in “bone on bone” contact, making even simple daily activities painful.
In shoulder replacement surgery, the arthritic portions of the shoulder are removed and replaced with an artificial component known as a prosthesis. Treatment options include replacement of just the head of the humerus bone, or replacement of both the ball and socket. Both procedures are known as a total shoulder arthroplasty (Figure 2).
Is it right for you?
Osteoarthritis (degenerative joint disease) is a common reason for people to have shoulder replacement surgery. While osteoarthritis generally occurs in people over 50, it can happen at a much younger age and can be associated with rheumatoid arthritis, post-traumatic arthritis, and rotator cuff tear arthropathy. Unfortunately, there is no way to prevent osteoarthritis.
Individuals with rotator cuff tear arthropathy lack the muscles surrounding the ball of the shoulder. For these patients, a procedure known as a reverse total shoulder arthroplasty (Figure 3) may offer pain relief and improved function. This procedure can also be effective for patients who have had a failed rotator cuff surgery.
You may want to consider shoulder replacement surgery if:
- You have severe pain that interferes with everyday activities such as reaching into a cabinet, dressing, going to the bathroom, or washing
- It is difficult to sleep because the pain prevents you from getting a good night rest
Before undergoing shoulder surgery, you should explore all possible non-surgical measures, including injections, physical therapy, and pain medicine. These treatments should continue as long as they are beneficial. If surgery is required, an in-depth medical history, physical examination, x-rays, and other tests will be conducted to ensure that you are a “good fit” to have a successful surgery.
While shoulder replacement is known to benefit individuals with arthritis of the shoulder, it’s important to remember that there are risks involved whenever surgery or anesthesia is needed, including infection and dislocation.
Immediately after surgery, you can expect to begin shoulder rehabilitation to regain your motion, strength and function, which usually includes physical therapy and a home exercise program.