What is Shoulder Replacement Surgery?

Shoulder replacement surgery refers to the surgical replacement of a diseased or injured shoulder with an artificial one. Typically, individuals who have conditions that produce severe pain and decreased range of motion, such as osteoarthritis, rotator cuff tears, shoulder fracture, and failed prior shoulder replacement surgery would be appropriate candidates for shoulder replacement surgery.

Although not as common as hip or knee replacement surgery, shoulder replacement surgery is very effective in relieving shoulder pain. Generally, if other non-surgical treatments such as medication and physical therapy are ineffective, shoulder replacement surgery may be recommended. The most common type of shoulder replacement surgery involves replacing the affected joint surface with a metal ball attached to a stem and plastic socket.

Sometimes, depending on the general condition of the shoulder, the surgeon may replace only the ball; this occurs in cases where the ball is severely damaged or fractured and the socket is normal. The decision to replace only the ball is usually made during surgery, or perioperatively, once the surgeon actually visualizes the condition of the shoulder. Occasionally, the surgeon may be able to ascertain this preoperatively, based on the results of medical imaging tests.

Typically, prior to shoulder surgery, the patient will need a preoperative medical evaluation to make sure he can withstand the procedure and general anesthesia. Usually, conditions such as a torn rotator cuff will require only shoulder arthroscopy surgery, which is a minimally invasive surgical procedure using only small incisions, a camera or scope, and small instruments. Total shoulder replacement surgery, conversely, will require open surgery.

Generally, during shoulder injury surgery, the orthopedic surgeon will separate the pectoral and deltoid muscles, allowing him access to the shoulder. Since the rotator cuff covers the shoulder, the surgeon must cut one of the front muscles of the cuff, so he can view and manipulate the damaged parts of the shoulder. After the affected shoulder sections have been removed, the surgeon will insert the implant, close and suture the rotator cuff, and finally, close and suture the surgical incision.

After shoulder replacement surgery, the arm will usually be immobilized at the patient's side, and he will be taken to the recovery room, where he will be monitored for pain, bleeding and abnormal vital signs. Normally, physical therapy will begin on the first day after shoulder surgery. Although it is ideal to begin physical therapy soon after surgery, commencement of rehabilitation may depend upon the patient's range of motion and implant stability.

Usually, the patient may use his arm for limited activity, beginning at approximately four weeks after surgery; unrestricted use of the affected arm may start after eight weeks. Possible complications that may occur after surgery may include infection, unstable implant and stiffness. Generally, after one year, most patients will enjoy pain free movement and function, which will further allow him to exercise the shoulder enough to promote excellent motion and strength.