Total Shoulder Replacement

You Don’t Have to Shoulder the Load…or Pain

The shoulder is a ball-and-socket joint - the round head (ball) of the upper arm bone fits into a shallow socket in the shoulder for a wide, constant range of motion. And, on any given day, our shoulders see a lot of action. As the most flexible joint in our body, they help us, push, pull, lift, reach and rotate our arms. Our shoulders give our arms the strength they need to help us do what we need to do.

Unfortunately, all that constant movement can lead to overuse or injury. 

If you have pain, stiffness or weakness in your shoulder, you may need more pain medication and physical therapy. You could need a new shoulder.

Replacing a Shoulder

According to the Agency for Healthcare Research and Quality, about 53,000 people in the U.S. have shoulder replacement surgery each year. Shoulder joint replacement may be less common than knee or hip replacement, but it’s just as successful in relieving joint pain.

“Shoulder replacement is less common than knee and hip replacements because arthritis in the shoulder in general is less common,” according to Gustavo Barrazueta, MD an orthopedic surgeon at Adena Orthopedic and Spine Institute. “This is because the shoulder doesn’t see as much weight as the hips and knees. The hips and knees see our body weight with every step we take.”

During a shoulder replacement (or shoulder arthroplasty), damaged areas of bone are removed and replaced with metal or plastic parts (implants).

Shoulder implants are available in a few different shapes and a range of sizes. Partial and total replacement options are available using either anatomic or reverse implants.

How it Works

Shoulder replacement surgery is performed to help relieve pain and other symptoms that result from damage to the shoulder joint.

Conditions that can damage the joint include:

• Osteoarthritis – Also known as wear-and-tear arthritis, osteoarthritis damages the cartilage that covers the ends of bones and helps joints move smoothly.
• Rotator cuff injuries - A rotator cuff is a group of muscles and tendons that surround the shoulder joint. Rotator cuff injuries are caused by damage to cartilage and bone in the shoulder joint.
• Fractures - Fractures of the upper end of the arm bone (or humerus) may require replacement.
• Rheumatoid arthritis - The inflammation caused by rheumatoid arthritis and other inflammatory disorders can damage the cartilage and the underlying bone in the joint.
• Osteonecrosis - Some types of shoulder conditions can affect blood flow to the humerus. When a bone doesn’t get enough blood, it can collapse.
  

Who Can Benefit from a Shoulder Replacement?

You may be a candidate for shoulder replacement surgery if you have the following symptoms: 

• Your shoulder pain is so severe that you struggle with everyday activities such as bathing, getting dressed and reaching into a cabinet. 
• You have a loss of motion in your shoulder. 
• You have weakness in your shoulder. 
• You have pain that’s so bad that it prevents you from getting a good night’s sleep. 
• You’ve tried anti-inflammatory medications, cortisone injections and physical therapy with no relief. 
• You have prior arthroscopic surgery, rotator cuff or fracture repair that failed to relieve your symptoms.
  

Types of Shoulder Replacements

Depending on the type of joint damage, there are a wide range of procedures available, including:

• Anatomic total shoulder replacement - Both the ball and the socket are replaced using implants that resemble the natural shape of the bones.
• Reverse total shoulder replacement - Both the ball and the socket are replaced, but the implants are reversed. The ball is attached to the shoulder blade and the socket is attached to the upper arm bone. This option is usually preferred when the rotator cuff is damaged.
• Partial shoulder replacement - Only the ball of the joint is replaced. It may be recommended when only the ball side of the joint is damaged.
  

Possible Risks

Though not common, potential complications of shoulder replacement surgery could include:

• Dislocation - The ball of your new joint could possibly come out of the socket.
• Fracture - The humerus bone, the scapula (shoulder blade) or the glenoid (socket) bone can break during or after surgery.
• Loosening implants -  Shoulder replacement components are durable, but they may loosen or become worn over time.
• Rotator cuff failure - The rotator cuff can occasionally wear out after a partial or total anatomic shoulder replacement.
• Nerve damage - Nerves around the implant area can be injured. Nerve damage can cause numbness, weakness and pain.
• Blood clots - Clots can form in the veins of the leg or arm after surgery. Clots like these are dangerous because a piece can break off and travel to the lung, the heart or (in rare cases) the brain.
• Infection - Infection can occur at the incision site or in the deeper tissue. Surgery is sometimes needed to treat it.
  

Talk to Your Doctor

Shoulder pain can impact every part of our everyday lives. If it’s causing you pain to the point that you can’t reach for things, aren’t sleeping well or experience other symptoms, your health care provider might consider replacement surgery – especially if you’ve tried nonsurgical treatments with no success.

Shoulder joint replacement surgery is a safe and effective procedure to relieve pain and help you get moving again without pain.

“While it is a big deal to go through, shoulder replacement surgery has very reliable and provides good results,” says Dr. Barrazueta. I always go over the process and recovery in great detail with patients interested in potentially having a replacement so I would advise them to come in and learn more about it.”