The shoulder is a ball and socket joint, meaning that the head of the upper arm bone (humerus) fits into a shallow socket (glenoid) in the shoulder blade. Like any joint, a healthy shoulder is lined with cartilage that acts as a shock absorber and allows the bones to move smoothly against each other.
When this cartilage is compromised by wear and tear, injury, or disease, it can no longer do its job properly. This can lead to severe shoulder pain, inflammation, and loss of mobility. In some cases, shoulder replacement surgery may be the best course of treatment. But how much do you know about shoulder replacements? How do you know if a shoulder replacement is right for you?
At Greater Pittsburgh Orthopaedic Associates (GPOA), our team of joint replacement specialists has helped countless patients get back to living their best lives. Using the least invasive techniques and state-of-the-art technology, we can provide you with individualized care that gets you back to doing the things you love.
Here are some of the most important things to know about shoulder replacements, along with five reasons you might need this procedure:
What is Shoulder Replacement Surgery?
Shoulder replacement surgery, also known as shoulder arthroplasty, is a procedure to resurface a damaged or diseased shoulder joint. This involves removing the damaged bone and cartilage and replacing it with an artificial joint made of metal, plastic, or ceramic.
Shoulder replacement surgeries can be performed in a few different ways. The most common types of shoulder replacement include:
- Total shoulder replacement: Total shoulder joint replacement surgery is the most common type of total shoulder replacement surgery. During a traditional total shoulder replacement, both the ball (humeral head) and the socket (glenoid) are replaced with artificial implants. This procedure is often recommended for patients with anatomic total shoulder replacement or rotator cuff tear arthropathy.
- Partial shoulder replacement: Partial shoulder joint replacement, also known as hemiarthroplasty, involves replacing only the damaged half of the joint, leaving the healthy half intact. If only the ball is damaged, it will be replaced with an artificial metal ball. If just the socket is damaged, it may be resurfaced with a metal cap. Physical therapy is typically recommended after this procedure to help with rehabilitation and recovery.
- Reverse total shoulder replacement: Reverse shoulder replacement is a newer procedure used for patients with severe rotator cuff tears who are not candidates for other types of surgery. During this procedure, the ball and socket are reversed, changing the mechanics of the joint. This allows the patient to lift their arm without relying on the rotator cuff tendons. Physical therapy is an important part of the recovery process after reverse shoulder replacement.
In some cases, shoulder replacement surgery may be accompanied by elbow surgery to address any additional issues in the upper extremity. It's important to consult with a qualified orthopedic surgeon to determine the most appropriate treatment plan for your specific condition.
How Does Shoulder Replacement Surgery Work?
During a traditional shoulder replacement surgery, which is performed under general anesthesia, your orthopedic surgeon will make an incision in the front of your shoulder. They will carefully detach the muscles and tendons surrounding the joint to gain access to the area. Once this is done, the damaged bone and cartilage will be removed, making way for the placement of the shoulder replacement implants. These implants are specifically designed to fit the upper arm bone and restore the functionality of the shoulder joint. The new joint will then be secured in place using special screws or pins. To complete the procedure, your surgeon will close the incision using stitches or staples and carefully cover it with a dressing.
After the artificial joint has been secured, the surgeon will reattach the previously detached muscles and tendons. This reattachment process is crucial as it ensures the stability of the new joint and restores the range of motion in the shoulder. The site is then cleaned and properly bandaged to minimize the risk of infection.
A shoulder replacement surgery typically takes about two hours, but this can vary depending on the complexity of the case. Once the surgery is completed, you will be moved to a recovery room where your vital signs will be monitored as the anesthesia wears off. Pain management is a crucial part of post-operative care and a medication plan will be provided to manage discomfort as your shoulder begins to heal.
Following the operation, a rehabilitation program, guided by a physical therapist, will be initiated. This will include exercises to improve shoulder strength and flexibility. It is imperative to follow this program diligently as it plays a significant role in the success of the surgery and the speed of your recovery.
Reverse shoulder replacement surgery is performed in a similar way, but the ball and socket are reversed, which changes the mechanics of the joint.
What Are the Benefits of Shoulder Joint Replacement Surgery?
Shoulder replacement surgery can provide a number of benefits, including:
- Pain relief: Shoulder replacement surgery can significantly relieve pain in those with chronic shoulder conditions. In many cases, the pain is completely resolved after surgery.
- Improved shoulder function: Shoulder replacement surgery can also improve your range of motion and allow you to return to your normal activities.
- A decrease in the need for pain medication: Most patients who have shoulder replacement surgery find that they no longer need to take pain medication.
Shoulder joint replacement surgery is a safe and effective procedure with a high success rate. In most cases, the benefits of shoulder replacement surgery far outweigh the risks.
5 Signs You Need Shoulder Surgery Now
1. You're Not Healing Well After a Serious Shoulder Injury
If you've suffered a serious shoulder injury, such as a dislocation or severe shoulder fractures, and you're not healing well after several months of conservative treatment, you may need a shoulder replacement.
A torn rotator cuff is a common shoulder injury that can sometimes be treated with surgery. But if you have a large rotator cuff tear and you're over the age of 60, your rotator cuff muscles may not heal well enough to avoid shoulder joint replacement.
2. You Have an Arthritic Shoulder
Shoulder arthritis is a common reason why people need a shoulder replacement. The most common type of shoulder arthritis is osteoarthritis, which occurs when the cartilage in the joint breaks down. This can happen due to normal wear and tear, or it may be the result of an injury.
Rheumatoid arthritis is another type of arthritis that can damage the shoulder joint. This form of arthritis is caused by an autoimmune disorder that causes the body's immune system to attack the tissues in the joints.
In cases of severe arthritis, the cartilage in your shoulder can become so worn down that you experience bone rubbing on bone. This can be extremely painful and make it difficult to move your shoulder.
3. You've Had Shoulder Surgery Before and It Failed
If you've had shoulder surgery in the past and it failed to relieve your pain or improve your shoulder function, you may need a shoulder replacement.
If you've had a previous shoulder replacement that failed, you may be a candidate for something called a revision shoulder replacement. Revision shoulder replacement is a more complex surgery than traditional shoulder replacement, but it can often provide successful results.
4. Non-Surgical Techniques Aren't Working
If you've tried conservative treatments for your shoulder pain and they're not providing relief, you may need a shoulder replacement.
Non-surgical treatments for shoulder pain include rest, ice, time with a physical therapist, and pain medicine. If these techniques aren't providing relief after several months, it may be time to consider surgery.
5. Severe Pain is Impacting Your Everyday Life
If you're experiencing severe shoulder pain that's impacting your ability to perform everyday activities, such as dressing yourself or reaching for items on a shelf, you may need a shoulder replacement.
Visit the Top Shoulder Specialist Near You
Shoulder pain can make simple tasks extremely difficult and can prevent you from enjoying your life. If shoulder pain is interfering with your quality of life, it may be time to visit an orthopedic surgeon for a shoulder replacement surgical procedure.
Greater Pittsburgh Orthopaedic Associates (GPOA) is a leading provider of orthopedic care in the Pittsburgh area. Our team of experienced orthopaedic surgeons can evaluate your shoulder and determine if shoulder replacement surgery is right for you.