The shoulder is a complex ball-and-socket joint that is capable of more than any other joint in the body. The shoulder is made up of three bones, including the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). The shoulder joint is where the ball of the humerus joins the socket of the scapula (glenoid cavity). The joint is secured and attached through soft tissues such as muscle, cartilage, ligaments, and tendons, including the rotator cuff tendons.
Significant joint damage is often repaired through various joint replacement, or joint arthroplasty, procedures. The most common joint replacement surgeries are total knee and total hip replacement. However, total shoulder arthroplasty, or total shoulder replacement, is also available and is a safe, proven solution to chronic shoulder joint damage.
During a shoulder replacement, the damaged bone and cartilage of the shoulder are removed and replaced with artificial components. Shoulder replacement surgery functions to provide pain relief for the patient and is also used to restore and maintain the function of the shoulder and arm.
For chronic problems involving injury and re-injury to the rotator cuff, reverse total shoulder replacement is a leading-edge solution to chronic pain. Click here to learn more about reverse shoulder replacement for rotator cuff tear arthropathy.
History of Injury: Although some people may need shoulder arthroplasty after an injury or severe fracture, more often, the procedure is performed on people who are dealing with the effects of various forms of arthritis. These include rheumatoid arthritis, or autoimmune-related chronic joint inflammation; post-traumatic arthritis, which occurs after injury; and osteoarthritis, or joint degeneration caused by years of wear and tear on the shoulder joint.
Diagnosis: Your surgeon will ask you questions about your general health as well as your shoulder joint pain and how it is impacting your ability to function. He or she will also perform a physical exam to assess the strength, range of motion, and stability of your shoulder. To better understand the location and the extent of the damage, you will have X-rays taken of your shoulder. Depending on your situation, your surgeon may also order blood tests or an MRI.
Treatment: Treatment depends on the extent and location of your shoulder damage. You may only need the head of your humerus bone (ball) replaced or both the humerus and the glenoid (socket).
Initial: Before recommending shoulder replacement surgery, your surgeon may suggest conservative treatments, such as non-steroidal anti-inflammatory medications, other pain medications, steroid injections, or physical therapy.
Long-Term: If nonsurgical treatments are not helpful or no longer relieve pain, shoulder replacement could be a good option for you.
Indications for Shoulder Replacement Surgery: If you have rheumatoid arthritis or osteoarthritis and your shoulder pain is interfering with your daily life—even while you are resting—you may be a good candidate for shoulder replacement. Patients with post-traumatic arthritis due to an injury or severe fracture may also benefit from shoulder replacement.
Shoulder Replacement Surgery: The procedure takes place in a hospital. After you are given general anesthesia, your surgeon will make an incision between two muscles on the front of your shoulder—the deltoid and the pectoralis major. Next, he or she will replace both sides of your joint, the humeral head (ball) and the glenoid (socket). The humeral component, or ball, is metal and is attached to a stem that’s secured inside the upper humeral canal. The glenoid component, or socket, is made from plastic and is secured into the scapula (shoulder blade).
Post-Surgery: After surgery, you will be moved to another room, where you will remain for several hours while you recover from your anesthesia. When you wake up, you will be wearing a sling. You should carefully follow your surgeon’s instructions regarding when you can remove the sling and move your elbow, wrist, fingers, and shoulder.
Rehabilitation: Your surgeon will provide you with specific instructions about what you can and cannot do while your shoulder is healing. You will need to keep the sling on for several weeks after surgery and do exercises and stretching activities consistently, at home or working with a physical therapist, to help your shoulder heal properly.
Risks and Complications: As with any surgery, there is a risk of infection or blood clots. You should avoid lifting heavy weights overhead with the weight behind your head, as doing so risks re-injuring your shoulder.
You should seek out an experienced orthopedic surgeon to perform your shoulder arthroplasty. This clinician should not only be skilled at performing the surgery but also have the ability to accurately assess the extent of the damage prior to surgery.
Our fellowship-trained shoulder surgeon, Dr. Leigh Brezenoff, is experienced and skilled in providing expert care for our shoulder patients. Though many shoulder conditions can be treated conservatively, there are injuries or conditions that may require surgery. Dr. Brezenoff also offers a number of specialized nonsurgical joint treatments including corticosteroid joint injections and viscosupplementation. Before recommending surgery, he also ensures that other measures have been taken to relieve your pain, including anti-inflammatory medications, injections, or physical therapy.
If shoulder surgery is necessary for you, Dr. Brezenoff has the advanced training and expertise to perform your total shoulder replacement surgery. He also offers several other advanced procedures, including:
At Litchfield Hills Orthopedic Associates, our orthopedic specialists and staff understand the first step towards reducing your shoulder pain and restoring your health is a proper diagnosis to determine the specific cause of your pain. Schedule a consultation with our specialty-trained shoulder specialist today, and discuss your condition and treatment options. You can request an appointment online or call (860) 482-8539 and be seen in Torrington or Bristol.