Total Shoulder Replacement
Total shoulder replacement, also known as total shoulder arthroplasty, is a surgical procedure that involves replacing the damaged or diseased shoulder joint with artificial components. The procedure is typically performed to relieve pain and restore function in individuals with severe shoulder arthritis or significant shoulder joint damage.
Here’s an overview of the total shoulder replacement procedure:
Pre-operative evaluation: Before the surgery, the patient undergoes a thorough evaluation, which may include physical examination, medical history review, imaging tests (such as X-rays and MRI), and blood tests. The surgeon assesses the extent of joint damage and determines the appropriateness of the procedure.
Anesthesia: Total shoulder replacement is usually performed under general anesthesia, which means the patient is asleep during the surgery. In some cases, regional anesthesia (such as a nerve block) may be used to numb the shoulder and arm.
Incision: The surgeon makes an incision over the shoulder joint, typically on the front or side. The length and location of the incision may vary based on the patient’s condition and the surgeon’s preference.
Joint exposure: The surgeon carefully moves or detaches the surrounding muscles and tendons to gain access to the shoulder joint.
Joint preparation: The damaged portions of the shoulder joint, including the head of the humerus (upper arm bone) and the glenoid (the socket of the shoulder blade), are removed.
Implant placement: The surgeon inserts the artificial components. These typically consist of a metal ball that replaces the humeral head and a plastic socket that replaces the glenoid. The components may be fixed to the bone using bone cement or may have a porous coating that allows bone to grow into the implant for better long-term stability.
Closure: The surgeon reattaches the muscles and tendons, and the incision is closed using sutures or staples. A sterile dressing is applied.
Post-operative care: After the surgery, the patient is moved to the recovery area. Pain medication, antibiotics, and other necessary medications may be prescribed. Physical therapy is a crucial part of the recovery process and helps restore strength, range of motion, and function in the shoulder joint.
It’s important to note that recovery times can vary depending on the individual, the extent of joint damage, and other factors. The surgeon will provide specific post-operative instructions, including restrictions on activities, exercises to perform, and follow-up appointments.
While total shoulder replacement can significantly reduce pain and improve shoulder function, it is still a major surgery with potential risks and complications. These may include infection, blood clots, nerve damage, implant loosening or dislocation, and stiffness. It’s essential to discuss the benefits and risks of the procedure with your orthopaedic surgeon to make an informed decision.
Total Shoulder Replacement FAQs
Total shoulder replacement, also known as total shoulder arthroplasty, is a surgical procedure in which the damaged parts of the shoulder joint are replaced with artificial components. The procedure is performed to relieve pain and improve function in patients with severe shoulder joint damage due to conditions like osteoarthritis, rheumatoid arthritis, or traumatic injury.
The duration of total shoulder replacement surgery can vary, but typically it takes around two to three hours to complete. However, the actual time may depend on various factors, including the complexity of the case and the surgeon’s experience.
The artificial components used in a total shoulder replacement consist of a metal ball (made of cobalt-chrome) that replaces the humeral head (upper arm bone), and a plastic socket (made of high-density polyethylene) that replaces the glenoid cavity (shoulder socket).
After surgery, you will spend some time in the hospital for monitoring and initial recovery. Physical therapy is an essential part of the rehabilitation process and usually begins soon after surgery. You will need to wear a sling for a few weeks to support the shoulder and protect the surgical site. Full recovery can take several months, and during this time, you will gradually regain strength and range of motion in your shoulder.
Like any surgical procedure, total shoulder replacement carries some risks, including infection, bleeding, blood clots, nerve damage, implant loosening, dislocation, and stiffness. Your surgeon will discuss these risks with you and take appropriate measures to minimize them.
The lifespan of a total shoulder replacement can vary among individuals. On average, a well-functioning shoulder replacement can last 15 to 20 years or more. However, the longevity of the implant depends on factors such as age, activity level, and overall health.
Yes, most patients can resume normal daily activities after a full recovery from total shoulder replacement. However, high-impact or repetitive activities, such as heavy lifting or contact sports, may need to be avoided to prevent excessive stress on the artificial joint. Your surgeon or physical therapist will provide specific guidelines regarding activities and restrictions.
In some cases, alternative treatments may be considered before opting for total shoulder replacement. These alternatives can include conservative measures like medications, physical therapy, cortisone injections, or arthroscopic surgery. The most appropriate treatment option will depend on the specific condition and its severity.