What Is Total Shoulder ⁤Replacement?

Total shoulder replacement is a surgical procedure in which a doctor removes the damaged ball portion of the shoulder joint and replaces‌ it‍ with‌ a prosthetic. The procedure is also known as shoulder arthroplasty or total shoulder arthroplasty.



The goal of total shoulder replacement is to reduce pain and improve joint function. The procedure is ⁢used to treat ⁢shoulder ⁣pain that is caused by osteoarthritis, rheumatoid arthritis, recurrent shoulder dislocations, or fractures and injuries.

Overview​ of Total Shoulder Replacement

During ⁤total shoulder replacement, a doctor first makes an incision in the shoulder to expose the joint. Next, they remove the damaged parts ⁢(ball and socket) and replace them with artificial parts.



The prosthetic used in total shoulder replacement is made of metal and a plastic or ceramic-like material. It is designed to fit perfectly in ‍the shoulder to reduce pain, improve ​stability, and minimize the ⁢chance of dislocations.

Benefits of Total Shoulder Replacement

Total shoulder ‌replacement offers several ‌benefits compared to more conservative‌ treatments such as medication and physical therapy. Some of the main benefits include:

• Reduced shoulder pain



• Increased mobility



• Reduced risk of‌ future injury or dislocation



• Long-lasting relief



• Minimally invasive‍ surgery with a short recovery time

Expected ⁣Results of Total Shoulder​ Replacement

The expected results of total shoulder replacement will ⁢vary from person to person. Generally,‍ people who undergo total shoulder replacement can expect:

• Pain reduction within a few weeks



• Improved⁤ mobility and joint function within several months



• Long-term pain relief and increased joint stability



• Shoulder ‍flexibility and strength may be ‌limited compared to before surgery

Risks of Total Shoulder Replacement

Total‍ shoulder replacement is a⁣ safe and effective procedure with very low risk ​of ‌complications. It is​ important to follow post-operative instructions carefully to reduce‌ the risk of infection, ⁣bleeding,⁣ and other complications.



Common ‌side effects ‌and risks of total shoulder replacement ​include:

• Infection



• Pain



• Stiffness



• Swelling



• Nerve damage



• Tendon, ligament, or muscle damage



• Fracture



• Loose or malpositioned implants

Recovery After​ Total Shoulder ⁢Replacement

Patients should plan on taking time off of work for at least four to six weeks to recover from ⁣total shoulder replacement.

Immediately After Surgery

Immediately following the surgery, the patient will ⁤need to have someone⁢ drive‌ them home, as they cannot operate a vehicle. They should also arrange for someone to help them with⁣ daily activities for the first week ‍or two.

Before Discharge

Before hospital discharge, the patient may begin ​physical therapy to⁣ help ​with recovery and proper positioning of the joint.

At Home

At home, the patient should limit activities for the first two weeks. They should not lift anything heavy or perform any activities that involve reaching, twisting, or bending.

Physical Therapy

After the initial two weeks of recovery, the⁣ patient should begin physical therapy. During ​physical⁣ therapy, the patient will ⁣do exercises‍ to increase flexibility, range of motion, and muscle strength. The duration and intensity of physical therapy‌ will vary depending on the individual’s ‌needs.

Conclusion

Total‌ shoulder ⁤replacement is a ⁣surgical procedure in⁤ which a doctor removes ⁤the damaged ball portion of the shoulder joint and‌ replaces it‍ with ‍a prosthetic. The overall goal of the procedure is to reduce pain, improve joint‍ function,⁣ and restore mobility.



Total shoulder replacement typically offers long-term relief for joint pain caused by arthritis or trauma. Common‍ risks of the procedure include infection,⁣ pain, stiffness, swelling,⁤ and nerve damage.



Patients should ⁤expect a recovery period at home and physical therapy before returning to their⁣ normal activities. To reduce the risk ⁤of complications, it is important to follow pre- and post-operative ‌instructions carefully.

Definition & Overview

Total shoulder replacement is a surgical procedure that replaces damaged shoulder joint with plastic or metal components, as the treatment for shoulder arthritis. Also known as total shoulder arthroplasty (TSA), it is intended to reduce pain and swelling, and to restore function and mobility in patients with end-stage arthritis of the shoulders.

Usually performed by an orthopaedic surgeon, the ends of the damaged upper arm bone as well as the shoulder bone are removed, and replaced with prosthetic parts that are cemented in place. The artificial components eventually integrate with the neighbouring bone structures as the movement becomes fully restored in the affected area.

Arthritis of the shoulder occurs when the cartilage and tendons in the upper shoulders deteriorate, usually due to age. As the joint surface progressively wears out, some areas of the bone become exposed and joint surfaces become rough. These result to friction and abrasion during movement, causing shoulder joints to become inflamed. This leads to severe pain, stiffness and often, loss of mobility in the shoulder area. This condition can be solved by a total shoulder replacement procedure.

Who Should Undergo and Expected Results

Patients who experience intolerable shoulder pain and stability caused by any of the following conditions may consider the procedure:

• Osteoarthritis – This is the most common reason for shoulder replacement and refers to age-related arthritis caused by the degeneration of cartilage
• Rheumatoid arthritis – A condition characterised by the inflammation of the membrane that surrounds the shoulder leading to cartilage degradation
• Post-traumatic arthritis – As the term implies, this is a type of arthritis that occurs following a serious injury
• Avascular necrosis – A very painful condition caused by lack of blood supply to the shoulder bone
• Rotator cuff tear arthropathy – A condition characterised by chronic rotator cuff tear, leading to arthritis

• Severe fracture – Fractures may cause the head of the upper bone arm to break or crack. In some cases, the only treatment available to restore shoulder appearance and function is total replacement
  Patients who will benefit from total shoulder replacement are those that:

• Experience severe shoulder pain that disables them from performing normal activities such as reaching, dressing, washing, and going to the toilet

• Experience severe pain in the shoulders even while resting that interferes with normal sleep
• Persistent weakness, numbness, and loss of motion in the shoulder
• Shoulder pain that does not go away even with anti-inflammatory medications, cortisone injections, painkillers, or physical therapy.
  The procedure has a high success rate in relieving pain caused by shoulder arthritis. After the procedure, physical therapy is performed to restore mobility in the shoulders.

How is the Procedure Performed?

Before TSA surgery, prior preparations have to be made. The orthopaedic surgeon may ask for a complete physical examination weeks before to ensure that the patient is medically fit for surgery.

Shoulder replacement is done under general or local anaesthesia and is highly technical. After the anaesthetic is in effect, an incision is made at a pre-planned location across the front of the shoulder to allow the surgeon access to the joint. Certain tendons are cut to remove the damaged and arthritic areas. The removed structures are then replaced with implant socket, ball, and stem component prosthetics that are carefully chosen to best match the anatomy. Surgeons also make sure that the new shoulder joint is not too loose or too tight to ensure proper restoration of muscle balance.

After the prosthesis is in place, the tendons and muscles are carefully repaired back and skin layers closed to complete the procedure. The entire surgery lasts two to three hours after which, patients spend about two hours in the recovery room and a few days in the hospital for monitoring.

Directly after a total shoulder replacement, patients feel some degree of surgery-related pain. However, the intensity is much less in degree compared to the pain felt prior to surgery. Antibiotic medications may be administered to prevent infection. To protect the shoulder area, a sling may be used for support for the next 2 to 4 weeks.

Physical therapy usually begins a day or two after surgery when pain becomes more manageable. The sooner the rehabilitation starts, the sooner it is for the patient to regain strength, flexibility, and mobility to the shoulders. The success of the operation is also highly dependent on physical therapy.

Possible Risks and Complications

Success rates of total shoulder replacement are very high. However, just like any surgical procedure, there is some degree of risk involved in this procedure. Complications rarely occur, and may include shoulder stiffness, infection, complications due to an adverse reaction to anaesthesia, nerve damage, instability of prosthetics, and loosening of glenoids.

References:

• Devinney DS, et al., (2005). Surgery of shoulder arthritis. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 1, pp. 995-1015. Philadelphia: Lippincott Williams and Wilkins.

• Nam D, et al. (2010). Reverse total shoulder arthroplasty: Current concepts, results, and component wear analysis. Journal of Bone and Joint Surgery, American Version, 92(Suppl 2): 23-35.

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