Total Shoulder Replacement
What is Total Shoulder Replacement?
Total shoulder replacement is an effective treatment to alleviate the severe pain and stiffness that often result from end-stage arthritis or degenerative joint disease. It involves replacing the diseased head of the humerus (arm bone) and arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket. These components come in various sizes and may be either cemented or press fit into the bone. The surgeon removes the humeral head, smooths and reshapes the shoulder socket, hollows out the upper portion of the humerus, implants the metal stem, attaches the metal head and joins the components to form a new shoulder joint.
In addition to osteoarthritis and rheumatoid arthritis, reasons for total shoulder replacement include avascular necrosis (loss of blood supply to the bones) and severe trauma from a shoulder fracture.
The shoulder is a ball-and-socket joint made up of three bones: the humerus, scapula (shoulder blade) and clavicle (collarbone). The bones are covered with articular cartilage for smooth, pain-free motion of the joint. The muscles and tendons that surround the shoulder provide stability and support. All of these structures allow the shoulder to rotate through a greater range of motion than any other joint in the body.
Osteoarthritis and rheumatoid arthritis cause the surface layer of cartilage to wear away. Without this cushioning effect, the bones of the shoulder joint rub together. The shoulder can't move easily and becomes stiff, swollen and painful.
When is Surgery Recommended?
If you have shoulder pain that limits your everyday activities and all non-surgical methods of treatment have failed – including anti-inflammatory medications, cortisone injections and physical therapy – then you should consider total shoulder replacement surgery.
A total shoulder replacement can alleviate pain, improve motion, strength and function, and help you return to the activities you enjoy. However, the way a shoulder replacement will ultimately perform depends on a number of factors, including a patient's age, activity level, and overall health. It is important that each patient is thoroughly screened by an orthopaedic surgeon to determine the most appropriate type of treatment.
What is the Recovery Time?
A careful, well-planned rehabilitation program is critical to the success of a total shoulder replacement. Most patients wear a sling for three to four weeks. Gentle physical therapy begins immediately following surgery to regain range of motion and progresses to include exercises that strengthen the shoulder joint. Total rehabilitation time usually takes several months, but as with all surgical procedures, specific recovery time varies by patient and demand.