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Frequently Asked Questions about Shoulder Replacement

• What is shoulder replacement?

Let’s start with the basics. Joint replacement is a surgical procedure aimed at relieving pain and improving function of the affected joint. If you are found to be a candidate for shoulder replacement, one of the first questions that you may ask is, “what is shoulder replacement?” Shoulder replacement is the removal of the damaged anatomy of the shoulder and the placement of artificial components, called a prosthesis. The areas of the shoulder that are replaced are the humeral head (known as the ball) and the glenoid (known as the socket).

• Is shoulder replacement right for me?

First and foremost, shoulder replacement should be a collective decision that is made with you and your physician. The decision for replacement is made with the patient’s well-being at the forefront of all discussions. The need for shoulder replacement will be determined based on your orthopedic evaluation. This evaluation will consist of: review of medical history and records, physical exam, x-rays, and additional tests if necessary such as an MRI. Depending on the severity of your shoulder injury, many conservative treatment options will be made available before shoulder replacement is considered. These options may include: anti-inflammatory medications, non-narcotic pain medications, steroid injections in the shoulder, and physical therapy.

• What causes someone to need shoulder replacement?

There are many different conditions that could lead to a person requiring shoulder replacement. One of the most common conditions we treat with replacement is an unrepairable rotator cuff tear. Sometimes surgery has been performed in the past unsuccessfully and a replacement can be a good option for patients who are not candidates for additional attempts at repair of the rotator cuff. Another condition is arthritis of the shoulder joint. Arthritis is generally described as the loss of cartilage in the joint. The cartilage serves as the cushion between the bones. We often make the comparison of cartilage to “tread on the tires”. Once we lose “tread,” or cushioning, bone rubs against bone causing pain and stiffness. Another common condition associated with replacement is a severe shoulder fracture. Occasionally there is too much damage for repair and the fractured part of the shoulder is replaced. Lastly, a failed shoulder replacement due to loosening or failure of parts, infection, and dislocation is a reason for possible revision. The revision of a shoulder replacement could consist of removal of previous placed components and the placement of a new implant.

• What types of replacement are there?

There are several types of shoulder replacement. There are many intricate details associated with the type of replacement. We will discuss the basics in differentiating two of the more common types of replacement: total shoulder replacement and reverse shoulder replacement. An in depth discussion will take place with your orthopedic surgeon if replacement is deemed necessary. A total shoulder replacement is known as the “traditional” replacement. The humeral head, also known as the ball, is replaced with a smooth metal surface. The glenoid, also called the socket, is replaced with a plastic surface for a new smooth gliding joint. This procedure is most commonly reserved patients with an intact rotator cuff.

Figure 1. Total Shoulder Replacement.

A reverse shoulder replacement is essentially the opposite of the traditional replacement. The ball of the traditional replacement is now attached to the glenoid or “socket” of the arm. The plastic surface is now placed at the humerus or “ball” of the arm. This procedure is most commonly reserved for patients who have a failed, torn, or weakened rotator cuff.

Figure 2. Reverse Total Shoulder Replacement.

• What can I expect with surgery?

Usually this procedure will allow for patients to come in the day of their surgery, barring any special circumstances. Shoulder replacement is an estimated 2 hour procedure. You will be likely stay overnight at the hospital where the surgical procedure takes place. You will be continuously monitored until you are cleared for discharge from the hospital the next day. In some circumstances, patients may be given the option outpatient (same day) joint replacement.

• What is the recovery protocol with shoulder replacement?

As with every surgical procedure, the recovery time is patient specific. As discussed earlier, the goal of the replacement is for the relief of pain and maintaining functional ability. These goals will be used to guide each patient through the recovery protocol associated with their replacement. The advancement through the protocol will be based on the recovery and healing process of each individual patient. This will be a collective decision between you and your orthopaedic specialist. Usually there are a total of 12 weeks of some type of lifting restriction. As with any orthopaedic surgery the time until maximum improvement is an estimated 1 year from surgery.

• How do I know if shoulder replacement is right for me?

If you are in need of an evaluation by one of our orthopaedic specialists, give us a call at 615-329-6600 and schedule your appointment today.