Shoulder replacement surgery is safe and effective to relieve pain and restore motion so you can return to the life you love. Recovery from a total shoulder replacement requires the patient’s commitment to extensive post-operative rehabilitation to achieve the full benefits from this surgery.
Who would benefit from shoulder replacement surgery?
- Those with severe shoulder pain that makes it difficult to use your arm and interferes with daily activities, and even sleep.
- Severe shoulder arthritis
- A severe shoulder injury that breaks the bone or a severely torn rotator cuff
- People who find that conservative treatments fail to provide pain relief.
What causes of severe shoulder pain?
- End stage osteoarthritis (wear and tear arthritis) or Rheumatoid arthritis that causes cartilage loss, pain, stiffness and disability.
- Post-traumatic arthritis following a severe shoulder injury.
- Rotator cuff tears that lead to arthritis
- Severe fractures that shatter the upper arm bone. Older people with osteoporosis are most at risk for severe shoulder fractures.
- Failure of a previous shoulder replacement.
What are the shoulder replacement options?
The goal of surgery is to treat severe pain and stiffness and restore function. The choice of procedure is determined the amount of healthy soft tissue including tendons and the rotator cuff.
Total Shoulder Replacement (TSA)
Total Shoulder Replacement is surgery to replace the damaged parts of the shoulder joint. The end of upper arm bone will be replaced, and the shoulder socket will be with re-surfaced. The repair will be done with anatomically correct metal and plastic components that are cemented or press-fit into the bone. Good quality bone is necessary for the press-fit implants.
Patients with bone on bone arthritis and intact rotator cuff tendons are the best candidates for this procedure. The goal is pain relief and secondarily to restore motion, strength and function. The patient can receive regional anesthesia and/or general, and often these are used together.
At six months most patients are pain free and have a return of nearly full motion and strength. At one year, more than 85% of patients will be pain free and without strength or motion limitations. The remaining 15% of patients will have improvements in pain and motion compared to their arthritic state.
Partial Shoulder Replacement
This surgery replaces only the head of the arm bone and improves mobility. The original socket is maintained. This is often used for young active patients and avoids complete replacement of the glenoid socket.
Reverse Shoulder Replacement
This approach is designed for patients who had a previous shoulder replacement that failed, and for patients with shoulder arthritis and massive rotator cuff tears. These patients usually have severe disability, loss of normal mechanics, and are unable to raise the arm away from the side beyond ninety degrees.
The reverse technique does not rely on the rotator cuff to move the arm. Instead, the deltoid muscle is used to move the arm. A reverse shoulder approach is the best solution when the damaged shoulder needs replacement parts, but there is not enough healthy tissue to stabilize the joint and move the arm.
Shoulder replacement surgery is an open surgical procedure. When the shoulder condition involves the ligaments, muscles, tendons or rotator cuff tears or disease, minimally invasive shoulder arthroscopy is an option. Your Grossmont Orthopedic surgeon will discuss the options with you.
The board certified and fellowship trained orthopedic surgeons at Grossmont Orthopaedics in La Mesa, California routinely performs shoulder replacements and complex shoulder reconstructions. Contact us to schedule a consultation to get the correct diagnosis and learn about your treatment options.