Total Shoulder Replacement
by Dr. Richard Bartholomew, Shoulder Surgeon Expert
Total Shoulder Replacement surgery, also known as Total Shoulder Arthroplasty, involves removing the arthritic shoulder joint and replacing it with a prosthesis. This procedure is an option given to patients who suffer from joint dysfunction. This is usually the result of osteoarthritis or rheumatoid arthritis, but more rarely for those who have sustained severe trauma from a shoulder fracture. Generally, all other modes of treatment are considered first, such as physical therapy and medication, but a total shoulder arthroplasty procedure can provide pain relief and increased mobility for those who have not experienced relief.
Total Shoulder Replacement Arthroplasty
Total shoulder replacement surgery alleviates pain by replacing the damaged bone and cartilage with a metal and plastic implant. The shoulder joint is a ball-and-socket joint, much like the hip joint. The ball is the top of the arm bone (the humerus), and the socket is within the shoulder blade (scapula). This joint allows people an enormous range of motion at the shoulder.
When shoulder replacement surgery is performed, the ball is removed from the top of the humerus and replaced with a metal implant. This is shaped like a half-moon and attached to a stem inserted down the center of the arm bone. The socket portion of the joint is shaved clean and replaced with a plastic socket that is cemented into the scapula.
For properly selected patients, a minimally invasive option is available. The new TESS shoulder is a lot less invasive with excellent outcomes. TESS Total Shoulder Replacement removes minimal amounts of bone compared to the traditional long metal stem of the humeral component and allows for a smooth articulation with the glenoid.
Who is a candidate for Shoulder Joint Replacement?
Patients who have tried the usual treatments for shoulder arthritis, but have not been able to find adequate relief, may be a candidate for shoulder replacement surgery. Patients considering the procedure should understand the potential risks of surgery, and understand that the goal of joint replacement is to alleviate pain. Patients generally find improved motion after surgery, but these improvements are not as consistent as the pain relief following shoulder replacement surgery.
How long does the total shoulder arthroplasty procedure last?
Total shoulder replacement surgery lasts about two hours. The incision for the surgery is along the front of the shoulder joint and usually about four to six inches long. The surgery is most commonly done under general anesthesia.
After the shoulder replacement surgery
Hospital stays vary from one to three days for most patients. You will be sent home wearing a sling, and you should not attempt to use the arm except as specifically instructed by your doctor. You will begin some motion immediately following surgery, but this may not be true in every case. Usually, within two to three months, patients can return to most normal activities and emphasize strengthening the muscles around the shoulder and maintaining range of motion. The recovery time is greatly decreased with the minimally invasive option — TESS total shoulder replacement.
Dr. Bartholomew treats painful shoulder conditions such as bursitis, tendonitis, calcium deposition, advanced arthritis, rotator cuff tears, and frozen shoulder.
