Shoulder Replacement Surgeries

If your shoulder joint gets seriously damaged, you might need surgery to replace it. Before you have your procedure, you should know some things.

About Shoulder replacement surgery

The joint where your upper arm connects to your body is a ball-and-socket joint. The bone in your upper arm, called the humerus, has a round end that fits into the curved structure on the outside of your shoulder blade.

Ligaments and tendons hold it together. Ligaments connect the bones, while tendons connect muscles to the bone. A layer of tissue called cartilage keeps the bones apart, so they don't rub against each other.

The ball and socket let you move your arm up and down, back and forward, or in a circle.

Why You'd Need It Replaced

You may have to have it done if you have a condition that makes it painful and hard to use your arm, such as:

• 1.A serious shoulder injury like a broken bone
• 2. Severe arthritis
• 3. A TORN ROTATOR CUFF

Your doctor will probably try to treat you with drugs or physical therapy first. If those don’t work, he may recommend surgery.

What to Expect

An orthopaedic surgeon will replace the natural bone in the ball and socket of your shoulder joint with a material that could be metal or plastic. It's a major surgery that'll keep you in the hospital for several days. You’ll also need several weeks of physical therapy afterward.

Types of Shoulder Replacement and Resufacing Options

Total shoulder replacement: Sometimes called traditional shoulder replacement or traditional shoulder arthroplasty, this surgery replaces the original ball-and-socket surfaces of the shoulder with similarly shaped prosthetics. Total shoulder replacement is considered the most reliable surgical option for relieving debilitating shoulder arthritis, but it is not appropriate for people who want to remain very active or have damaged rotator cuff muscles.

Partial shoulder replacement: During a partial shoulder replacement, or shoulder hemiarthroplasty, the arm's humeral head is removed and replaced with a prosthetic ball but the natural socket, or glenoid bone, is kept.

Reverse shoulder replacement: During reverse shoulder replacement the surgeon switches, or reverses, the positions of the shoulder joint's ball and socket. The ball at the top of the humerus (upper arm bone) is replaced with a socket-shaped prosthetic, while the shoulder's natural socket is fitted with a prosthetic ball. This surgery is an option for people whose damaged rotator cuffs make them ineligible for traditional shoulder replacement. It changes the center of rotation of the joint, enabling other muscles to compensate for a lack of rotator cuff function.

Shoulder Resurfacing (resurfacing hemiarthroplasty) During this surgery the damaged humeral head is fitted with a smooth rounded cap to facilitate better joint movement. Unlike a stemmed hemiarthroplasty, shoulder resurfacing does not require the complete removal of the natural humeral head nor the insertion of a prosthetic humeral stem.

Who May Be Ineligible for Total Shoulder Replacement Surgery?

Not everyone who has shoulder arthritis is a candidate for total shoulder replacement. Factors that can affect patient eligibility include:

Nicotine use

Joint replacement patients who smoke or use other tobacco products face higher post-surgical complication rates. For example, a survey of more than 500 people who underwent knee replacement surgery found that smokers were about 10 times more likely to have had a revision surgery

Tobacco users can lower their post-surgical risks by quitting or cutting back on use prior to surgery. For total shoulder replacements, the surgery involves cutting through the rotator cuff tendon and repairing it at the end of the procedure. Nicotine use has been shown to inhibit healing following rotator cuff repairs.

Infection

Doctors consider infection a serious complication. A patient may need to postpone surgery or consider non-surgical treatment options if he or she has:

• 1. Systemic infections
• 2. Predisposition to infection
• 3. Skin problems that can limit wound healing or increase the risk of infection

Osteoporosis

Severe osteoporosis can cause bones to be too brittle to properly support and adhere to a prosthesis. On the other hand, mild to moderate osteoporosis may simply affect how a surgeon plans for surgery. For example:

• 1. The surgeon may decide to use fast-acting bone cement to attach the new socket to the natural bone instead of using a cementless fixation method.
• 2. The surgeon may ask the patient take steps to improve bone density before and after surgery to enhance the lifespan of the shoulder replacement.