Shoulder replacement surgery may be necessary when damage to the shoulder joint significantly impacts daily activities. Conditions affecting the shoulder can cause severe pain, weakness, and stiffness.
In this procedure, a skilled surgeon removes the damaged bone and replaces it with metal and plastic implants, providing the necessary support for comfortable shoulder function.
Shoulder implants come in various shapes and sizes, tailored to meet each patient’s unique needs.
Anatomy of the Shoulder
The shoulder is composed of three bones: the clavicle, scapula (shoulder blade), and humerus (upper arm bone). This complex network of bones, joints, and soft tissues allows for a wide range of motion. The shoulder joint is a ball-and-socket joint, where the rounded head of the upper arm fits into a shallow socket in the shoulder.
Why Shoulder Replacement Surgery is Performed
Shoulder replacement surgery is designed to alleviate pain and other symptoms resulting from shoulder joint degeneration. Some common conditions that may lead to shoulder damage include:
- Osteoarthritis: This degenerative joint disease occurs when flexible tissue at the ends of bones wears down over time, leading to pain in the shoulders, neck, knees, and hips. Treatment options include medications, physical therapy, or surgery.
- Fractures: Fractures at the upper end of the shoulder may require replacement surgery, especially if previous treatments have failed. Fractures can result from trauma, overuse, or conditions that weaken bones.
- Rotator Cuff Tears: The rotator cuff consists of muscles and tendons surrounding the shoulder joint. Difficulty with arm movement may indicate a partial or complete rotator cuff tear.
- Rheumatoid Arthritis: This inflammatory disease affects joints, causing severe swelling and discomfort. It arises from an overactive immune system that attacks the body’s own tissues.
Risks and Complications
While shoulder replacement surgery can reduce pain and improve mobility, it may not eliminate pain entirely. Potential risks and complications include:
- Nerve Damage: Injury to nerves in the shoulder area can result in weakness, pain, and numbness.
- Infection: There is a risk of infection in the deeper tissues following implant placement, which may require additional surgery.
- Dislocation: The joint may become dislocated if the ball falls out of its socket after surgery.
- Implant Loosening: Although shoulder implants are durable, they may loosen or wear down over time, necessitating further medical intervention.
- Blood Clots: Post-surgery, blood clots can form in the arm veins, which may lead to serious complications if they travel to the lungs, heart, or brain.
Types of Shoulder Replacement Procedures
The choice of shoulder replacement procedure depends on the severity of the condition and the surgeon’s recommendation:
- Anatomic (Standard) Total Shoulder Replacement: Both the ball and socket are replaced with implants designed to mimic the natural shape of the bones.
- Partial Shoulder Replacement: Only the ball of the joint is replaced, recommended when damage is limited to one side.
- Reverse Total Shoulder Replacement: The surgeon removes the rounded head of the upper arm and the socket of the shoulder blade, then secures implants to the remaining bone.
Preparing for Surgery
Before surgery, the surgeon will conduct various tests for accurate diagnosis and treatment planning, including:
- Assessment of symptoms
- Physical examination
- X-rays
- CT scan of the shoulder
After evaluating these findings, the surgical team will proceed with the operation. Post-surgery, the surgeon will suggest exercises to aid recovery and improve mobility.
What to Expect on the Day of the Procedure
Before Surgery: Follow your surgeon’s pre-operative instructions carefully the day before and on the day of the surgery.
During Surgery: You will be sedated to ensure comfort and deep sleep. A nerve block will be administered to numb your shoulder, controlling pain throughout the procedure, which typically lasts 2-3 hours.
After Surgery: Post-operative care includes resting and avoiding rapid shoulder movements. A supportive wrap may be used to relieve discomfort.
