Total Shoulder Arthroplasty

What is Shoulder Replacement Surgery?

Total shoulder arthroplasty involves removing damaged bone and cartilage from the healthy shoulder joint and replacing it with a prosthetic joint. The surgery typically addresses pain and loss of function caused by arthritis, fractures, or other degenerative conditions affecting the shoulder.

What Conditions Can Total Shoulder Arthroplasty Treat?

Several conditions may lead a physician to recommend shoulder surgery, including:

• Osteoarthritis: Age-related wear and tear that causes joint pain and stiffness.
• Rheumatoid Arthritis: An autoimmune condition leading to chronic inflammation in the joints.
• Post-Traumatic Arthritis: Joint damage from previous injuries, such as fractures or dislocations.
• Rotator Cuff Injuries: Severe damage or tears to the rotator cuff tendons lead to joint degeneration.
• Avascular Necrosis: Loss of blood supply to the bone, causing joint deterioration.
• Severe Fractures: Complex fractures that cannot be adequately treated with other surgical options.

How Do I Know if I Need Shoulder Replacement Surgery?

Persistent pain, limited range of motion, and difficulty performing everyday tasks are common signs that you may need shoulder replacement surgery. If non-surgical treatments—like injections, medications, or physical therapy—haven’t provided sufficient relief, it may be time to explore surgical options.

Your doctor will evaluate your medical history, perform a physical exam, and review imaging studies to determine whether total shoulder arthroplasty is appropriate for you.

Who Are Good Candidates for Shoulder Replacement?

Candidates for total shoulder arthroplasty typically have the following characteristics:

• Severe shoulder pain: Pain that interferes with sleep or daily activities and is not relieved by other treatments.
• Loss of motion and strength: Inability to lift objects or limited mobility in the shoulder.
• Lack of improvement with conservative treatments: Non-surgical treatments like physical therapy, anti-inflammatory medications, or injections have been tried with minimal success.

Ultimately, your eligibility for surgery is determined by a comprehensive evaluation with your surgeon, who will consider your overall health, level of disability, and the condition of your shoulder.

The Shoulder Replacement Procedure

The procedure for total shoulder arthroplasty generally involves several steps:

1. Anesthesia: You will receive either general anesthesia or regional anesthesia with a nerve block to ensure comfort during the procedure.
2. Incision: The surgeon makes an incision at the front of your shoulder to access the joint.
3. Joint Preparation: Damaged bone and cartilage are removed from the joint.
4. Implant Placement: The humeral head (the ball of the shoulder joint) is replaced with a metal ball, and the glenoid (the socket) is replaced with a plastic component.
5. Reconstruction and Closure: The joint is reconstructed, and the incision is closed with sutures or staples.

The type of implant used will depend on your specific condition, bone quality, and the surgeon’s recommendations.

Types of Shoulder Replacement Implants

The shoulder is a ball and socket joint where the upper arm bone fits into the shoulder blade, allowing a wide range of motion. Shoulder replacement implants imitate the function of this joint. There are several types of implants used in shoulder joint replacement surgery, including:

• Anatomic Total Shoulder Replacement: This option closely mimics the natural anatomy of the shoulder, using a metal ball and a plastic socket.
• Reverse Total Shoulder Replacement: In cases where the rotator cuff is damaged or non-functional, a reverse shoulder replacement may be recommended. This design switches the positions of the ball and socket, allowing other muscles to compensate for the loss of rotator cuff function.
• Partial Shoulder Replacement: Also known as hemiarthroplasty, this option replaces only the head of the humerus while preserving the natural socket.

Your surgeon will choose the most suitable implant type based on your individual needs and the condition of your shoulder.

What Are the Risks of Shoulder Replacement Surgery?

As with any surgery, there are potential risks associated with total shoulder arthroplasty. These may include:

• Infection: Although rare, infections can occur and may require further treatment.
• Implant loosening or wear: Over time, implants may wear down or become loose, potentially requiring revision surgery.
• Nerve or blood vessel injury: Injury to surrounding structures is uncommon but possible.
• Blood clots: There is a small risk of developing blood clots after surgery.

Your surgeon will discuss these risks with you in detail and take steps to minimize them.

Recovery Time After Total Shoulder Arthroplasty

Recovery time varies, but most patients can expect to regain function and reduce pain within a few months. The initial recovery phase involves wearing a sling and engaging in gentle physical therapy. Full recovery and return to normal activities may take six months to a year, depending on factors like age, health, and adherence to rehabilitation protocols.

Following surgery, your doctor will provide a personalized recovery plan that includes physical therapy exercises, activity restrictions, and follow-up appointments to monitor your progress.

Explore Your Treatment Options

If you’re living with chronic shoulder pain and limited mobility, total shoulder arthroplasty may be the solution you need. At Georgia Hand, Shoulder & Elbow, our team in Marietta and Atlanta, GA, is committed to helping you regain your quality of life through expert care and personalized treatment options.

Contact us today to schedule a consultation and learn more about how shoulder replacement surgery could benefit you!