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Shoulder Replacement

When is it time to consider shoulder replacement surgery?

And what type of surgery is right for you?

Shoulder replacement surgery requires careful thought and planning, but for those who’ve exhausted other treatment options, it can be the best way to restore range of motion, relieve pain and help you return to an active lifestyle.

Many different conditions can lead to the severe pain and joint degeneration that necessitates a shoulder replacement, including various types of arthritis (osteoarthritis, rheumatoid arthritis, post-traumatic arthritis), serious fractures, or a combination of muscle tears and arthritis (such as rotator cuff tear arthropathy).

Understanding the source and nature of your shoulder pain will allow your orthopedic specialist to recommend the right procedure. Depending on the severity and type of condition, there are three types of shoulder replacements that are often considered.

Partial shoulder replacement surgery is often recommended when there is major damage to the head or ball of the upper arm bone (humerus), but the rest of the shoulder is healthy and intact. In this procedure, the ball portion of the upper arm bone is removed and replaced with metal.

Total shoulder replacement surgery is typically used to address arthritis and replaces both the damaged ball (the head of the humerus bone) and socket with metal and/or plastic. While total shoulder replacement recovery can take several months, patients often experience significant improvements in pain and motion following successful surgery and rehabilitation.

Otherwise healthy adults whose rotator cuff and deltoid are intact tend to be good candidates for total shoulder surgery. While there are few age or weight limits obesity, nicotine use and advanced age always increase the risk for post-surgical complications. Patients with severe osteoporosis or susceptibility to infections also have higher risks. 

Reverse shoulder replacement surgery may be the best option when there is significant damage to the shoulder tendons, namely the rotator cuff. If the shoulder joint is arthritic and there is a rotator cuff tear that cannot be repaired, a reverse shoulder replacement may be the best option for surgical treatment.

In this procedure, a prosthetic “ball”, usually metal, is placed on the shoulder socket. A plastic “cup” is then placed where the arthritic ball of the shoulder used to be. In doing so, the anatomy of the shoulder is “reversed” and the deltoid muscle is used to move the shoulder rather than the torn rotator cuff tendons.

Advanced Orthopedic has 10 board certifiedsurgeons who specialize in treatment of shoulder issues. The American Academy of Orthopaedic Surgeons considers patients with the following situations potential candidates for reverse rotator cuff surgery:

• A completely torn rotator cuff that cannot be repaired
• Rotator cuff tear arthropathy
• A previous shoulder replacement that was unsuccessful
• Severe shoulder pain and difficulty lifting your arm away from your side or over your head
• A complex fracture of the shoulder joint
• A chronic shoulder dislocation
• A tumor of the shoulder joint
• Patients who have tried other treatments, such as rest, medications, cortisone injections, and physical therapy, that have not relieved shoulder pain

If shoulder pain is severely limiting your daily activities or range of motion,and any of these descriptions apply, it might be time to raise your hand for shoulder replacement surgery. Contact our office to set an appointment.

Best Shoulder Surgeons

A. Todd Alijani, MD

Dr. A. Todd Alijani



Dr. Mark Failinger


James Ferrari, MD

Dr. James Ferrari


Wayne Gersoff, MD

Dr. Wayne Gersoff


Davis Hurley, MD

Dr. Davis Hurley


Cary Motz, MD

Dr. Cary Motz


H. Andrew Motz, MD

Dr. H. Andrew Motz



Dr. Justin Newman


John Papilion, MD

Dr. John Papilion


Dr. Micah Worrell

Dr. Micah Worrell


Shoulder Replacement

Does chronic shoulder pain mean it’s time for a shoulder replacement?

If recurrent shoulder pain is interfering with your daily life, it may not mean that you need a Shoulder Replacement but you may benefit from being seen by an orthopedic shoulder specialist.  Because shoulder pain can have multiple causes, your physician should include a complete medical and personal history in evaluating your shoulder concerns.

Causes

Shoulder pain has many causes such as contact occurring during impact sports like football or hockey, overuse or repetitive motion such as in baseball, and arthritis due to wear and tear or age.

While some pain can be addressed with non-surgical intervention such as rest, ice and anti-inflammatory medications, other causes require surgical treatment such as shoulder replacement.  Complex fractures, muscle and tendon tears that cannot be repaired and severe forms of arthritis may require shoulder replacement to give you the best chance at improved long-term comfort, mobility and function. 

Types of Shoulder Replacement surgery

Many people are surprised to learn that there is more than one type of shoulder replacement.  The type of replacement your specialist recommends will depend on the type of injury or reason for your shoulder pain.  The options include a partial shoulder replacement as well as a total or reverse total shoulder replacement.

Partial shoulder replacement focuses on the upper arm bone (known as the humerus) rather than the actual shoulder socket.  In this procedure, the ball portion of the upper arm bone is removed and replaced with metal. This type of shoulder replacement is recommended when there is major damage to the head or ball of the humerus bone while the rest of the shoulder is healthy and intact.

Total shoulder replacement is most often used to address arthritis in the shoulder and typically replaces both the damaged ball (the head of the humerus bone) and socket with metal and plastic. Total shoulder replacement patients can experience significant improvements in pain and movement following successful surgery and rehabilitation.

Reverse shoulder replacement is an option for shoulder pain resulting from arthritis in addition to significant damage to the shoulder tendons, namely the rotator cuff.  The “reverse” of a conventional total shoulder replacement, the ball and socket position are actually switched – the prosthetic ball is fixed to the socket, and the socket “cup” is fixed to the upper end of the humerus in place of the ball. This procedure relies on the deltoid muscle, instead of the rotator cuff tendons, to move the shoulder and arm.

Recovery from Shoulder Replacement surgery

What to expect

Patients should expect a complete recovery to take approximately six months.  That timeframe can vary, however, depending on factors such as the type of surgery, age, physical fitness prior to surgery, the severity of the injury, and – very importantly – your recovery and rehabilitation protocol.

In my practice, I typically recommend patients begin physical therapy as soon as one week after surgery starting with certain movements that begin to restore flexibility but also allow for healing. As time passes, strength work and additional flexibility exercises are introduced. All physical therapy is led by a highly trained physical therapist under the direction of your orthopedist.

Post-op Expectations 

Plenty of data exists on the benefits of shoulder replacement surgery and the majority of patients have excellent outcomes.  Studies report that 75-90% of patients return to their exercise or activity of choice with swimming, fishing, golf, and tennis players being most likely to return to their sport.

If you are tired of chronic should pain and it is impacting your daily activities, schedule a consultation with my office or another orthopedic specialist to find the right treatment plan for you.

Shoulder Replacement Specialists

James Ferrari, MD

Dr. James Ferrari

H. Andrew Motz, MD

Dr. Andy Motz

John Papilion, MD

Dr. John Papilion