What Is A Shoulder Replacement?

Shoulder replacement surgery is an orthopaedic procedure that involves replacing damaged parts of a shoulder joint with artificial components. The procedure is typically performed to relieve severe pain and restore function in patients who have significant damage to the shoulder joint.

When Is A Shoulder Replacement Necessary?

If you are experiencing severe shoulder pain and limited range of motion, you might find some relief with non-surgical treatments, such as physical therapy, pain medication, or injections. Should the non-surgical treatments fail to work over a period of time, however, your doctor might suggest a shoulder replacement. Shoulder replacement surgery is usually done when there is severe damage to the shoulder joint caused by arthritis, injury or disease. 

Arthritis

Arthritis is the most common reason for shoulder replacement surgery. Osteoarthritis is when the cartilage in the shoulder joint wears away, causing the bones to rub against each other, leading to pain and stiffness. Post-traumatic arthritis can occur after a severe shoulder injury, such as a fracture or dislocation, which damages the cartilage and bone in the shoulder joint. Rheumatoid arthritis is a chronic autoimmune disease that can cause inflammation and damage to the shoulder joint.

Shoulder Injuries

Injuries to the shoulder can cause damage to the bones and soft tissues that make up the joint, which might need surgery to be repaired. A rotator cuff tear, for example,  is a common injury that occurs due to overuse, trauma, or degeneration of the rotator cuff tendons, which attach the shoulder blade to the upper arm bone. 

When the blood supply to the bones in the shoulder joint is interrupted, it causes the bone tissue to die and collapse. This is a condition called avascular necrosis. 

If a previous shoulder surgery did not improve the patient’s condition, another shoulder replacement surgery might be necessary to restore function to the joint.

What Happens During A Shoulder Replacement?

During shoulder replacement surgery, the damaged parts of the shoulder joint are removed and replaced with artificial components, called prostheses. The procedure is typically performed under general anaesthesia, which means you will be asleep during the surgery.

The surgeon will make an incision in the front or side of the shoulder to access the joint and will then remove the damaged parts of the shoulder joint, including the ball (the head of the upper arm bone) and the socket (the glenoid of the shoulder blade).

The surgeon will then attach the prosthetic components to the remaining healthy bone using specialized instruments. The prosthetic components typically consist of a metal ball and stem inserted into the upper arm bone and a plastic socket inserted into the shoulder blade.

After the prosthetic components have been implanted, the incision will be closed with sutures or staples, and a sterile dressing will be applied.

After Shoulder Replacement Surgery

You will be monitored in a recovery area and given pain medication as needed. Physical therapy will also be started soon after surgery to help regain strength and mobility in the shoulder.

The surgery can take several hours, and recovery time can vary depending on factors such as age, overall health, and the extent of the surgery. 

What Are The Different Types Of Shoulder Replacement Surgeries?

There are three main types of shoulder replacement surgeries. The decision about which type of surgery to perform will be made based on a careful evaluation of the patient's individual circumstances and needs.

Total Shoulder Replacement

In a total shoulder replacement, the entire shoulder joint is replaced with an artificial joint. The damaged ball and socket are removed, and a metal ball and plastic socket are implanted. Total shoulder replacements are commonly used for patients with osteoarthritis or rheumatoid arthritis.

Partial Shoulder Replacement

A partial shoulder replacement is also known as a hemiarthroplasty, and is used when only one part of the shoulder joint is damaged, usually the ball (the head of the humerus). The damaged part is replaced with a metal ball, and the socket (the glenoid of the scapula) is left intact. 

Reverse Total Shoulder Replacement

In reverse total shoulder replacements, the ball and socket components are switched, so the metal ball is attached to the shoulder blade, and the plastic socket is attached to the upper arm bone. Reverse total shoulder replacement is often used in patients with a torn rotator cuff who have developed severe arthritis or in patients who have had previous shoulder surgeries that were unsuccessful.

What Are The Risks Of Shoulder Replacement Surgery?

As with any surgery, shoulder replacement surgery comes with potential risks and complications. It's important to discuss the risks and potential complications of shoulder replacement surgery with your doctor and to follow their instructions carefully during the recovery period to minimise the risk of complications.

Your doctor will prescribe antibiotics and take preventive measures to reduce the risk of infection, but it can still occur. If an infection does occur, it may require further treatment or surgery. Some patients may have an allergic reaction to the materials used in the prosthetic components or to the anaesthesia. 

Damaged Nerves

The nerves around the shoulder joint can be damaged during surgery, leading to weakness or numbness in the arm or hand. It's common to have some stiffness in the shoulder after surgery, and physical therapy is usually necessary to restore the full range of motion. Pain is a common side effect of surgery, but it usually goes away with time and medication. 

Blood Clots

Although the formation of blood clots (known as deep vein thrombosis) is very rare, they can form in the deep veins of the body - often in the legs.  If blood clots form and travel to the lungs, it can be life-threatening. Blood thinners and other measures are taken to reduce this risk. 

What Are The Benefits Of Shoulder Replacement Surgery?

One of the primary benefits of shoulder replacement surgery is long-term pain relief. Shoulder pain can make it difficult to sleep, but after surgery, patients may experience improved sleep quality and duration.

By reducing pain, improving function and aiding in better sleep, shoulder replacement surgery can have a positive impact on a patient's overall quality of life, allowing them to enjoy activities and hobbies they were unable to do before. Shoulder replacement surgery can also improve shoulder strength. This can help patients perform activities that require lifting and carrying heavy objects. 

Understanding Shoulder Replacement Surgery

Shoulder replacement surgery is an orthopaedic procedure that is typically performed to relieve severe pain and restore function in patients who have significant damage to the shoulder joint. The most common reasons for shoulder replacement surgery are arthritis, injury or disease. There are three main types of shoulder replacement surgeries: total, partial, and reverse total shoulder replacements.

As with any surgery, there are potential risks and complications involved. However, the benefits of shoulder replacement surgery include long-term pain relief and improved range of motion. It is important to discuss the risks and potential complications of shoulder replacement surgery with your doctor and to follow their instructions carefully during the recovery period to minimise the risk of complications.