Shoulder Replacement

Although shoulder joint replacement is less common than knee or hip replacement, it is just as successful in relieving joint pain.
Today, about 53,000 people in the U.S. have shoulder replacement surgery each year, according to the Agency for Healthcare Research and Quality. This compares to more than 900,000 Americans a year who have knee and hip replacement surgery.
If nonsurgical treatments like medications and activity changes are no longer helpful for relieving pain, you may want to consider shoulder joint replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain and help you resume everyday activities.
 
Description
In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis. The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid).
 
Is Shoulder Joint Replacement for You?
The decision to have shoulder replacement surgery should be a cooperative one between you, your family, your family doctor, and your orthopaedic surgeon.
There are several reasons why you may be a candidate for shoulder replacement surgery. People who benefit from surgery often have:
  • Severe shoulder pain that interferes with everyday activities, such as reaching into a cabinet, dressing, toileting, and washing.
  • Moderate to severe pain while resting. This pain may be severe enough to prevent a good night's sleep.
  • Loss of motion and/or weakness in the shoulder.
  • Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, or physical therapy.
 
 

Shoulder Replacement Options

There are different types of shoulder replacements. We will discuss with you which type of replacement would best meet your health needs. Do not hesitate to ask what type of implant will be used in your situation, and why that choice is right for you.
 
Total Shoulder Replacement
The typical total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket.
 
These components come in various sizes. They may be either cemented or "press fit" into the bone. If the bone is of good quality, your surgeon may choose to use a non-cemented (press-fit) humeral component. If the bone is soft, the humeral component may be implanted with bone cement. In most cases, an all-plastic glenoid (socket) component is implanted with bone cement.  This shoulder is advisable for the patient with normal osteoarthritis of the shoulder with a functioning rotator cuff
 
Resurfacing Hemiarthroplasty
Resurfacing hemiarthroplasty involves replacing just the joint surface of the humeral head with a cap-like prosthesis without a stem. With its bone preserving advantage, it offers those with arthritis of the shoulder an alternative to the standard stemmed shoulder replacement.
Resurfacing hemiarthroplasty may be an option for you if:
 
  • The glenoid still has an intact cartilage surface
  • There has been no fresh fracture of the humeral neck or head
  • There is a desire to preserve humeral bone
 
For patients who are young or very active, resurfacing hemiarthroplasty avoids the risks of component wear and loosening that may occur with conventional total shoulder replacements in this patient population. Due to its more conservative nature, resurfacing hemiarthroplasty may be easier to convert to total shoulder replacement, if necessary at a later time.
 
Reverse Total Shoulder Replacement
Another type of shoulder replacement is called reverse total shoulder replacement. Reverse total shoulder replacement is used for people who have:
 
  • Completely torn rotator cuffs with severe arm weakness
  • The effects of severe arthritis and rotator cuff tearing (cuff tear arthropathy)
  • A severe fracture
  • Had a previous shoulder replacement that failed
 
For these individuals, a conventional total shoulder replacement can still leave them with pain. They may also be unable to lift their arm up past a 90-degree angle. Not being able to lift one's arm away from the side can be severely debilitating.
 
In reverse total shoulder replacement, the socket and metal ball are switched. That means a metal ball is attached to the shoulder bone and a plastic socket is attached to the upper arm bone. This allows the patient to use the deltoid muscle instead of the torn rotator cuff to lift the arm.