What is Shoulder Replacement Surgery
Shoulder replacement surgery, or shoulder arthroplasty, removes damaged areas of bone and replaces them with metal or plastic implants to artificially restore the shoulder joint. Three types of operation fall within surgery to replace the shoulder joint, each to relieve pain and restore the range of motion, but are recommended depending on the type and extent of damage the joint has endured.
When is Joint Replacement Needed in the Shoulder
The shoulder consists of a ball and socket joint, which can be difficult to move and painful due to damage from medical conditions like arthritis or shoulder trauma. Common reasons shoulder arthroplasty can be recommended include:
- Fractures: When a fracture occurs at the upper end of the humerus, joint replacement surgery may be required.
- Osteoarthritis: This disease is known as "wear-and-tear" arthritis and damages the cartilage which covers the end of bones, helping the joints to move smoothly.
- Osteonecrosis: This is when the bone is starved of blood, which can develop from other shoulder conditions that disrupt the flow of blood to the humerus.
- Rheumatoid arthritis: A disease caused by an overactive immune system, creating inflammation that damages the cartilage and, in some cases, the underlying bone in the joint.
- Rotator cuff injuries: These are injuries to the group of tendons and muscles that surround the shoulder joint, causing further damage to the cartilage and bone in the joint.
Types of Joint Replacement Shoulder Surgery
There are several types of shoulder replacement surgery that an orthopedic surgeon can recommend. Which type of shoulder joint surgery chosen will depend on the type and extent of damage done to the joint.
Shoulder replacement surgeries include:
Partial Shoulder Replacement
The ball, or head, of the joint is replaced with a prosthesis. This type of shoulder replacement surgery is usually performed when only the ball side of the joint is damaged.
Reverse Total Shoulder Replacement
This version of shoulder replacement removes both the ball and the socket in the shoulder and replaces them with the implants. Instead of being placed in their natural position, the implants are reversed. The ball is attached to the shoulder blade while the socket is attached to the upper arm bone. This surgery is generally preferred when the rotator cuff is severely damaged.
Anatomic Total Shoulder Replacement
A version of total shoulder replacement where the ball and socket implants must resemble the natural shape of the bones.
Hemiarthroplasty
In this shoulder replacement operation, only the ball and stem are replaced. The stem is then connected to the ball and hinged to the natural socket
Shoulder Replacement Surgery Overview
Shoulder replacement surgeries, no matter the specific type, generally follow the same steps during the procedure and in their pre/post-surgery processes:
Preparing for Shoulder Surgery
The orthopedic surgeon will look over the symptoms and perform a physical exam, which can include X-rays and a CT scan. These imaging tests will help determine if shoulder replacement surgery is needed and what type of surgery will better the damaged joint.
If the surgery is needed, the surgeon will require clearance from the patient’s primary care physician. This permission communicated any chronic conditions the surgeon should be aware of and if the patient is healthy enough for surgery, any medications being taken, and ensure a better recovery process with home planning.
Before the surgery itself, a healthcare provider will discuss anesthesia options, what to expect during the surgery, and answer any questions the patient may have.
Overview of Shoulder Replacement Surgery
The specific techniques used during the shoulder surgery depend on the type of shoulder replacement being performed. Generally, the methods used are minimally invasive, needing fewer incisions which lessens the recovery time.
After removing the damaged joint, the surgeon will place the artificial joint (prosthesis) before using surgical glue, stitches, or staples to close the incision and bandage the area. Depending on the type of shoulder replacement performed, a brace or sling may be needed during recovery.