What is a Total Shoulder Replacement?
Total shoulder replacement, also known as total shoulder arthroplasty, is a well-established surgical procedure used to treat severe shoulder pain and stiffness caused by end-stage arthritis or degenerative joint disease. The primary purpose of shoulder replacement surgery is to relieve shoulder pain. Secondary goals are to restore motion, function and strength to the shoulder joint. The orthopedic shoulder specialist at The Shoulder Clinic of Idaho are highly skilled in total shoulder replacement surgery. They offer patients in Boise, Meridian, Nampa, and the surrounding communities of the Treasure Valley who have exhausted all other shoulder treatment options, the best outcomes in shoulder arthroplasty.
Why would I need a total shoulder replacement?
The shoulder joint is lined with cartilage which helps protect the bones and allows for a smooth, pain free range of motion. When the cartilage begins to wear away or when the shoulder joint surface becomes irregular due to prior injuries or prior shoulder surgeries, arthritis can begin. Shoulder arthritis refers to a “painful, stiff, rough, inflamed shoulder joint.” Years of wear and tear to the shoulder joint can advance to become osteoarthritis which is a form of arthritis also commonly referred to as degenerative joint disease. Osteo-meaning bone and arthritis, meaning inflamed joint, can cause symptoms of persistent shoulder pain, swelling, and limited range of motion. Many patients will also describe and suffer from symptoms of shoulder crepitus. Crepitus is a roughness or catching sensation that patients feel inside their shoulder when irregular surfaces of the shoulder joint rub or catch on one another. Patients who have tried non-surgical measures to treat their shoulder, yet still suffer from painful shoulder symptoms may be a candidate for shoulder replacement surgery.
Is it time for shoulder arthroplasty?
The decision to have shoulder replacement surgery should be carefully considered. There are several reasons why your orthopedic surgeon and shoulder specialist at The Shoulder Clinic of Idaho would recommend total shoulder arthroplasty:
- Shoulder pain that interferes with daily activities, such as dressing, driving or reaching above the shoulder.
- Pain that prevents a good night’s sleep.
- Loss of motion and shoulder stiffness that makes it difficult to move the shoulder.
- Failure of other therapies that have not helped diminish shoulder pain such as:
- Corticosteroid Injections
- Non-Steroidal Anti-inflammatory medications (NSAIDs)
- Physical Therapy
- Previous arthroscopic surgery
- Activity modification
How is total shoulder replacement surgery done?
A total shoulder arthroplasty is performed through a small open incision to access the shoulder joint from the front of the shoulder. The damaged humeral head (top of the arm bone) is replaced with a metal ball. The glenoid (shoulder socket) is resurfaced with a new, smooth plastic surface allowing smooth comfortable range of motion of the shoulder. Resurfacing the shoulder socket with a medical-grade plastic helps perform the job the cartilage would have done if it were still functioning normally. The new shoulder pieces (humeral ball and shoulder socket) together are called a prosthesis. These pieces (prothesis) are kept in place with tight-fitting components and medical bone cement. The metal ball on the smooth plastic surface allows for the return of a smooth, pain free motion in the shoulder joint. Of all the procedures performed in the shoulder – a total shoulder arthroplasty is one procedure that can reliably return a patient’s shoulder comfort and function when performed correctly for the right shoulder diagnosis.
How long will a shoulder replacement last?
A shoulder prosthesis (metal ball and plastic cup or socket) can wear out over time. Therefore, the orthopedic shoulder specialists at The Shoulder Clinic of Idaho recommend careful consideration of total shoulder replacement for their patients. A shoulder replacement may be expected to last between 10-20 years and is dependant on multiple factors that may be unique to the particular patient and shoulder problem for which the replacement is performed. For younger, active patients, joint preservation and minimally invasive surgeries may be considered to help prolong the comfort and function of the shoulder.
What are the recovery steps after a total shoulder replacement?
Patients who undergo shoulder arthroplasty can expect significant pain reduction and functional improvement of their shoulder. It is important to follow your surgeon’s protocol for proper healing after surgery. Here are some things to expect:
- Surgery is typically done on an in-patient basis staying one night at the hospital.
- Immediately following surgery, patients will need to follow their surgeons recommendations regarding pain medication and therapy exercises specific to their shoulder surgery.
- Swelling and pain are normal after surgery, but will gradually decrease.
- Cold compresses or ice therapy can help with swelling and pain.
- The arm is placed in a sling, directly after surgery to protect the shoulder and to provide comfort, as well as to alter those around you that you have recently undergone a surgical procedure.
- Stretching exercises directed by a physical therapist will begin right away to safely regain range of motion and to begin to get the new joint working.
- Patients are restricted from certain motions and activities for six weeks, depending on your shoulder surgeon’s recommendations.
- Most patients can expect to perform normal daily activities without pain in 3-4 months.
For more information about a total shoulder replacement, or if you would like to be evaluated by our shoulder experts, please contact The Shoulder Clinic of Idaho, serving Boise, Meridian, Nampa, and the surrounding communities of the Treasure Valley.