Total Shoulder Arthroplasty

Shoulder joint replacement is not as common as knee or hip replacement, but it can be successful in relieving joint pain.

As difficult as this may be to believe, shoulder replacement surgery was first performed in the United States back in the 1950s for the treatment of shoulder fractures. As time passed, shoulder joint replacement has been used to treat conditions such as arthritis.

Every year in the United States, a little more than 50,000 people have shoulder replacement surgery, According to Healthcare Research and Quality. Compared to the nearly 1 million people who undergo knee and hip replacement each year, it is clear that shoulder replacement is not very common.

If nonsurgical methods such as changes in activities and medications do not help in relieving pain, your doctor may recommend shoulder joint replacement surgery. Joint replacement surgery is a safe and effective surgical procedure that can both relieve the pain you are experiencing and help you resume daily activities.

No matter whether you have just begun exploring your different treatment options or have already decided to pursue it, this article is intended to help you understand this procedure more fully.

Description

As far as shoulder replacement surgery is concerned, it involves removing damaged parts of the shoulder and replacing it with artificial components, called a prosthesis.

Most times, there are two options. One where just the head of the humerus bone (ball) is replaced, and another where both the ball and socket (glenoid) are replaced.

In most standard shoulder replacement surgeries, the arthritic joint surfaces are replaced with a highly polished metal ball that is attached to a stem, as well as a plastic socket.

The components used in shoulder replacement surgery come in a variety of sizes. They are either “press fit” or cemented into the bone. If the bone is in good shape, your surgeron may opt for a press fit humeral component. If the bone is soft, the humeral component may be secured by way of cement. In almost all cases, and all-plastic glenoid (socket) component is secured with cement.

Implantation of an artificial glenoid component is not advised if:

  • The glenoid cartilage is in good shape
  • The glenoid bone is in very poor shape, or deficient
  • The tendons of the rotator cuff are irreparably torn

Patients who suffer from bone-on-bone osteoarthritis and intact rotator cuff tendons are usually great candidates for a conventional total shoulder replacement.

Your Surgery

Before Your Operation

You will be advised to wear loose-fitting clothes and a buttoned shirt when you go to the hospital or surgery center for your surgery. Once your surgery has been completed, you will be using a sling and will have limited use of your arm.

Most often, you will be admitted to the hospital on the day of your surgery. Once you have been admitted, you will be taken to the preoperative area and will meet a doctor from the anesthesia department.

A discussion between you, your anesthesiologist, and your doctor will take place in order to determine the best anesthesia option for you. Patients are typically given either a general anesthetic, where you are asleep for the entire operation, or a regional anesthetic that only numbs the area near where the surgery will take place. On occasion, a combination of the two will be used.

Surgical Procedure

In total, a shoulder replacement surgery takes somewhere in the neighborhood of one to two hours.

Once the surgery has been completed, you will be transported to a recovery room where you will remain until you full recover from the anesthesia that was administered. Once you wake up, you will then be taken to your hospital room.

Your Recovery at Home

When you leave the hospital, your arm is going to be supported by a sling. The sling is necessary to protect your shoulder for the first two to four weeks following your procedure.

Depending on your exact surgery, your incision wound will be sealed by way of staples or a suture underneath the skin. Staples are removed a few weeks following surgery, but sutures do not require any maintenance afterwards.

Until the wound has thoroughly dried and sealed, it is important to refrain from soaking it in water. You will be advised to continually bandage the wound as to avoid irritating it with clothing.

As far as home care is concerned, it is important to note that exercise will go a long way in helping you recover. Your surgeon will have developed an exercise plan for you, and it is important that you follow it in order to regain strength. Within two weeks following surgery, most patients are able to perform simple tasks such as eating, dressing themselves, and grooming themselves. There may be a bit of lingering pain that will last for a few weeks.

You will have to wait at least two and as many as four or more weeks after surgery before you can drive.

Outcomes

Once you have fully recovered from your operation, you should be able to lift your arm above shoulder height and bend your elbow such that you can reach the top of your head or into a cupboard. Shoulder replacement has been heralded for its ability to relive pain, resulting in incredibly high levels of patient satisfaction.

It is also recommended that you take oral antibiotics prior to any future dental appointments to significantly reduce the risk of infection.