What is Shoulder Joint Replacement?
Total shoulder replacement surgery is performed to relieve symptoms of severe shoulder pain and disability due to arthritis. In this surgery, the damaged articulating parts of the shoulder joint are removed and replaced with artificial prostheses. Replacement of both the humeral head and the socket is called a total shoulder replacement.
The shoulder is a highly movable body joint that allows various movements of the arm. It is a ball and socket joint, where the head of the humerus (upper arm bone) articulates with the socket of the scapula (shoulder blade), which is called the glenoid. The two articulating surfaces of the bones are covered with cartilage, which prevents friction between the moving bones. The cartilage is lubricated by synovial fluid. Tendons and ligaments around the shoulder joint provide strength and stability to the joint.
What is Arthritis?
When the cartilage is damaged, the two bones rub against each other causing pain, swelling and stiffness of the joint. This condition is called arthritis. There are many types of arthritis. Osteoarthritis (wear-and-tear brought about by old age) and rheumatoid arthritis (autoimmune disease) are two forms of arthritis.
What are the Indications for Shoulder Joint Replacement?
Total shoulder joint replacement is a surgery indicated for conditions such as osteoarthritis or rheumatoid arthritis when medication, injections, physical therapy, and activity changes do not help relieve pain. Your doctor recommends surgery when you have the following symptoms:
- Severe shoulder pain that restricts daily activities
- Moderate to severe pain during rest
- Weakness and/or loss of motion
Preparation for Shoulder Joint Replacement
To decide whether total shoulder replacement is a good option for you, Dr. Sellers will evaluate your condition thoroughly.
Dr. Sellers reviews your medical history and performs a physical examination of your shoulder to assess the extent of mobility and pain. Imaging tests such as X-ray or MRI (magnetic resonance imaging) are ordered.
Shoulder Joint Replacement Procedure
The surgery is performed under regional or general anesthesia. An incision is made over the affected shoulder and the underlying muscles are separated to expose the shoulder joint.
The upper arm bone (humerus) is dislocated from the glenoid socket of the shoulder bone. The arthritic or damaged humeral head is cut with a saw and removed. Next, the arthritic part of the socket is prepared, and the plastic glenoid component is fixed into the shoulder blade bone. A metal ball with a stem is then gently press-fit into the humerus.
After the artificial components are implanted, the joint capsule and rotator cuff is stitched, and the wound is closed.
Postoperative Care for Shoulder Joint Replacement
After the surgery, medications and antibiotics are prescribed to control pain and prevent infection. Your arm may be secured in a sling or immobilizer. The rehabilitation program includes physical therapy, which is started soon after the surgery and is very important to strengthen and provide mobility to the shoulder. You may be able to perform gentle daily activities two to six weeks after surgery.
Risks and Complications of Shoulder Joint Replacement
As with any major surgery, there may be potential risks involved:
- Anaesthetic complications such as nausea, dizziness, and vomiting
- Infection of the wound
- Dislocation, requiring repeat surgery
- Damage to blood vessels, nerves or muscles
- Failure to relieve pain
- Pulmonary embolism
- Wear and tear of the prosthesis
- Proximal Biceps Tenodesis
- Intraarticular Shoulder Injection
- Arthroscopic Acromioplasty
- Shoulder Joint Replacement
- Reverse Shoulder Replacement
- Rotator Cuff Repair
- SLAP Repair
- Arthroscopic Bankart Repair
- Arthroscopic Frozen Shoulder Release
- Latarjet Procedure
- Shoulder Arthroscopy
- Distal Clavicle Excision
- Pectoralis Major Tears/Repairs
- ORIF of the Clavicle Fractures
- Arthroscopic Superior Capsular Reconstruction (SCR)
- Subacromial Decompression
- Shoulder Resurfacing
- Acromioclavicular (AC) Joint Reconstruction