About Shoulder Replacement
The shoulder is a ball and socket joint. In patients with shoulder arthritis the cartilage on the ball and socket deteriorates. As this process worsens, the joint surfaces become rough and this makes the shoulder stiff and painful. This surgery replaces the damaged surfaces of the joint with artificial parts and aims to reduce your shoulder pain and improve your movement. A total shoulder replacement is where both the ball and the socket components are replaced. Depending on the damage to your shoulder, your surgeon may replace just the ball component – a procedure called a hemiarthroplasty.
Anatomy
The surgery is performed through an incision on the front of the shoulder. The damaged surfaces are replaced with metal and plastic components which move well against each other. The exact details of your surgery depends on what type of joint replacement you are having. Your surgeon can explain this in more details to you.
Types of Shoulder Replacement
Total shoulder replacement which involves replacing both sides of the joint – the ball and the socket, is recommended for patients who have severe arthritis that is causing pain, stiffness, and limited motion.
Hemiarthroplasty
This less invasive procedure involves replacement of the ball only. The socket portion is left intact. The procedure is for patients who do not have severe degeneration of the socket (glenoid).
Reverse Shoulder Replacement
Reverse shoulder replacement is reserved for patients who have arthritis and a chronic rotator cuff tear or in some instances a failed prosthesis and have no other treatment alternatives. In this procedure, the location of the prosthetic ball and socket components are switched to make use of healthy deltoid muscle rather than the damaged rotator cuff muscles to lift the arm.
Factors to Consider Shoulder Replacement:
- Constant pain in the shoulder
- Inability to move/ lift the shoulder
- Interference in activities of daily life
- Continuous use of painkillers required
- Limited movement of shoulder giving pain in the back and neck
If you answered YES to any of these questions, then Shoulder Replacement Surgery is worth exploring.
Post Op Recovery
Patients who have total shoulder replacement remain in the hospital for about two days. It is important to maintain motion in the shoulder, and physical therapy is begun on the first postoperative day and continued throughout the hospital stay.
Patients return home with their arm in a sling to be worn for three weeks. The arm is removed from the sling for physical therapy and home exercises. The sling should also be worn during sleep, and the arm should be elevated using a pillow. Patients are advised to ice the site three times a day and continue with formal physical therapy two to three times a week to increase range of motion. Patients can shower on the second post-operative day. The majority of patients undergoing shoulder replacement will have excellent pain relief and start active range of motion within six weeks. At six weeks, patients begin strengthening exercises with light weights and resistance bands. By twelve weeks, both strength and function of the shoulder should be dramatically improved.