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Total Shoulder Replacement & Reverse Shoulder

Shoulder replacement surgery is an option for treatment of severe arthritis of the shoulder joint. Arthritis is a condition that can cause the normal smooth cartilage lining of the joint to erode. As the cartilage wears away, the protective layer between the bones is lost. When this happens, painful bone-on-bone arthritis can develop. Severe shoulder arthritis is often painful, and can cause restriction of shoulder motion. While this may be tolerated with some simple treatments including medications and lifestyle adjustments, there may come a time when surgical treatment is necessary.

Shoulder replacement surgery, also called Arthroplasty:

Involves the replacement of the damaged bone and cartilage with metal and plastic implants. Shoulder Arthroplasty is a treatment option that can relieve pain and restore function. Very often, people tolerate their symptoms for long periods of time because the arm is not a weight bearing extremity. For this reason, arthritis of the shoulder is not as common as in the hip and knee. As such, most people know someone who has had a hip or knee replacement, but many people do not even know that shoulder replacement is an option.


Non-Surgical Techniques:

Physical therapy to improve flexibility and muscle strength in the shoulder is usually the first step in addressing rotator cuff injuries. Your therapists may also apply heat treatments to help ease your pain and stiffness. They may recommend ways for you to do your daily activities, such as housework and meal preparation, in a manner that puts less stress on your joints. Injections of corticosteroid medication can help reduce pain and swelling in people with severe and persistent injuries.

Shoulder Arthroplasty is recommended when non-surgical treatments have provided minimal or no improvement of your symptoms. The goal of Shoulder Arthroplasty is to relieve pain and restore shoulder mobility.

Total Shoulder Replacement Surgery:

Is recommended for people with bone-on-bone Osteoarthritis and intact rotator cuff tendons. This is the most common type of shoulder replacement surgery. Your surgeon will make an incision, approximately six inches long, on the front of your shoulder joint. Your surgeon will replace the damaged head of the humerus with a highly polished metal ball. The metal ball may be surgically implanted in the humerus or attached with surgical cement, depending on the condition of the bone. The glenoid is replaced with a plastic socket.

A Reverse Total Shoulder Replacement Surgery:

Is recommended for people with completely torn rotator cuffs, severe arthritis with cuff tear arthropathy, or prior failed shoulder surgery. Traditional total shoulder replacement would still leave these individuals with pain and the inability to lift their arms above their shoulders. In a Reverse Total Shoulder Replacement Surgery, the ball and the socket are switched. The metal ball is attached to the scapula, and the socket is attached to the end of the humerus. This allows the deltoid muscles, instead of the damaged rotator cuff muscles, to lift the arm above the shoulder. 

Another form of replacement is resurfacing Arthroplasty when the cartilage is removed from the humeral head and a metal “cap-like” prosthesis is placed over it.

Do’s and Don’ts After Surgery:

The success of your surgery will depend largely on how well you follow your orthopaedic surgeon’s instructions at home during the first few weeks after surgery.

Here are some common do’s and don’ts for when you return home:

  • Don’t use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.
  • Do follow the program of home exercises prescribed for you. You may need to do the exercises 2 to 3 times a day for a month or more.
  • Don’t overdo it! If your shoulder pain was severe before the surgery, the experience of pain-free motion may lull you into thinking that you can do more than is prescribed. Early overuse of the shoulder may result in severe limitations in motion.
  • Don’t lift anything heavier than a glass of water for the first 2 to 4 weeks after surgery.
  • Do ask for assistance. Your physician may be able to recommend an agency or facility if you do not have home support.
  • Don’t participate in contact sports or do any repetitive heavy lifting after your shoulder replacement.
  • Do avoid placing your arm in any extreme position, such as straight out to the side or behind your body for the first 6 weeks after surgery.

Many thousands of patients have experienced an improved quality of life after shoulder joint replacement surgery. They experience less pain, improved motion and strength, and better function.