Considering Shoulder Replacement Surgery? Start Here
If you suffer from a condition that causes chronic shoulder pain, such as arthritis, you may be considering shoulder joint replacement as a possible option for relieving that pain and regaining your freedom and mobility. Considering a joint replacement of any kind is a big decision, so we want our patients to be as informed as possible about the process and what to expect before making the final call. This post will review some information about shoulder replacements and what you need to know before you decide.
The shoulder is a ball-and-socket joint made up of 3 main parts: your upper arm bone (the humerus, ulder blade (the scapula) and your collarbone (the clavicle). When a shoulder is healthy, these bones are covered with cartilage and a lubricating membrane that keeps movements smooth and friction minimal. This gives your shoulder the tremendous range of motion that it is capable of when healthy.
There is a range of different injuries that the shoulder can be susceptible to, but the most common reason for people to consider shoulder replacement surgery is chronic pain.
One of the main causes of this type of pain is osteoarthritis, which is a wearing away of the shoulder cartilage after years of wear and tear. Once the cartilage and membranes that keep the shoulder joint smooth wear away, the bone-on-bone rubbing that results causes stiffness and soreness in the joint, which can significantly limit range of motion and mobility.
Other causes for shoulder replacement surgery include different types of arthritis – such as rheumatoid or post-traumatic arthritis – as well as the after effects of severe fractures or rotator cuff tears. Some patients also consider shoulder surgeries after developing a condition called avascular necrosis, which limits blood supply to the bones and causes death of bone cells and arthritis.
How Do I Know If I Need Shoulder Surgery?
Prime candidates for shoulder surgery often experience some of the following problems:
- Shoulder pain that limits daily activities like brushing your teeth or getting dressed
- Discomfort that causes loss of sleep or an inability to rest easily without significant pain
- Inability to improve your condition through the use of medication, physical therapy or other treatments
- Significant loss of range of motion in the shoulder joint
Sound like you? Then you very well might be a great candidate for a shoulder replacement surgery. But your decision-making process isn’t over yet. It’s very important that you consult with your physician and/or an orthopaedic surgeon about your condition.
A simple visit to your doctor’s office will allow you to consult with a professional who can make a better assessment of your condition and advise you about the best way to proceed.
Depending on your condition, there are a variety of different surgery options available to you, and you may not need a total replacement to achieve the results you’re looking for. The main types of shoulder replacement include:
Total Shoulder Replacement
This option is taken in serious cases where pain requires that the entire joint be replaced. If there is still cartilage in the shoulder socket, total replacement may not be necessary. The most ideal patients for total shoulder replacement experience bone-on-bone friction in the joint but still have healthy rotator cuffs.
The surgery involves replacing the upper humerus with a polished metal ball, then replacing the shoulder socket (also called a glenoid) with a new plastic socket. It’s a complete overhaul of the shoulder joint, and can relive patients of pain they’ve been feeling as a result of their worn down shoulder joint.
Hemiarthroplasty is a replacement of only the ball of your shoulder. If your socket is still healthy and has good cartilage left, your doctor might recommend a stemmed or resurfaced hemiarthroplasty.
The stemmed version of the surgery involves a replacement of the ball and attached stem bone in the upper humerus.
In a resurfacing hemiarthroplasty, the surgeon only replaces the top of the humeral cap, leaving the remaining humerus bone intact.
Reverse Total Shoulder Replacement
Reverse total shoulder surgeries (one of our specialties at Excelsior) are ideal for patients who’ve suffered complete or partial rotator cuff tears and are suffering from a great deal of pain or weakness as a result. This option is also recommended to patients who’ve had previous shoulder replacement surgeries that have failed.
In a reverse total shoulder surgery, the shoulder socket and metal ball piece completely switch places. The metal ball is attached to the shoulder bone, and the socket piece is then attached to the stem of the humerus.
This surgery essentially changes the muscle groups used to gain range of motion. After reverse total shoulder surgery, the patient will use the deltoid muscles at the top of the shoulder instead of the rotator cuff, which is why this surgery is ideal for people with torn rotator cuff muscles.
What to Expect
In many cases, these shoulder replacements can relive a patient of pain and help them regain significant range of motion, but not every surgery is guaranteed to be an easy fix. Even after the surgery, you may experience complications such as infection, shoulder dislocation or nerve injuries. Just because your new shoulder is made of metal parts, it won’t be immune to injury and wear, just like a normal shoulder.
The best person to consult about any possible drawbacks of the surgery is your doctor or your orthopaedic surgeon. They’ll be able to fully analyze the possible benefits of the surgery with you and advise you as to what you can expect when it’s all over.
After your surgery, your doctors will prescribe you with pain medication and antibiotics to help prevent infection. You will likely be able to leave the hospital within the first couple days after surgery, but that will vary from person to person, and it’s important to remember that your healing process is not over when you leave the hospital.
Shortly after your surgery, your doctors will start you on a physical therapy and exercise program, which is an extremely important step in your recovery. Your shoulder will need to heal after such an intensive surgery, and you’ll need to build your strength back up if you want to regain range of motion.
After your surgery, it’s also important not to overdo it. Be sure not to lift any heavy objects until you’ve completely healed, and avoid putting your arm in awkward positions that your muscles might not be ready for yet. If you haven’t regained range of motion, don’t lift your arm up over your head or reach it far behind your back. It’s usually best to follow this advice for up to 6 weeks after your surgery, or until your doctor has advised you that you can go back to more strenuous activity.
Roughly 53,000 shoulder replacement surgeries are administered in the US every year, and many patients can experience great results and relief of pain by having the surgery. But, remember that any joint replacement is a very intensive operation, and you should have all the facts before you decide to go forward.
To get more education on shoulder replacement surgeries, head over to our shoulder surgery page where you can watch informative videos about the different surgery types and meet our team of specialized doctors and surgeons.