Total Shoulder Replacement
Understand the Shoulder & Its Joints
The shoulder is a ball-and-socket joint that enables you to raise, twist
and bend your arm. It also lets you move your arm forward, to the side
and behind you. In a normal shoulder, the rounded end of the upper arm
bone (humeral head) glides against the small dish-like socket (glenoid)
in the shoulder blade (scapula). These joint surfaces are normally covered
with smooth cartilage. They allow the shoulder to rotate through a greater
range of motion than any other joint in the body.
Indicators for a Total Shoulder Replacement
The most common indication for total shoulder replacement is
shoulder pain due to arthritis or degenerative joint disease that cannot be controlled
with non-operative treatment. Accompanying the pain is a progressive stiffness
and loss of motion and/or a grinding or grating sensation.
Benefits of a Total Shoulder Replacement
primary benefit is pain relief, with a secondary benefit of restoring motion, strength, and function.
Pain relief, however, is the most predictable benefit of shoulder replacement,
gains in range of motion and strength are less predictable. Partial shoulder
replacement (hemi-replacement) may also be indicated with certain severe
shoulder fractures of the humeral head.
During and After the Procedure
Total shoulder replacement involves replacing the joint ball and the socket
with an implant (prosthesis). There are many different types of implants,
and your orthopedic surgeon will decide which is best for you. Implants
contain a ball with a stem that extends down inside the patient’s
upper arm bone (humerus) and a socket that is placed over the surface
of the patient’s glenoid.
The most recently developed implants allow for the new humeral head to
conform to the patient’s exact anatomy, and a cementless stem that
allows for the ingrowth of bone into the prosthesis. Depending on the
condition of the shoulder, your surgeon may replace only the ball. Sometimes
this decision is made in the operating room at the time of the surgery.
You will be admitted as an inpatient, and the procedure will be done in
one of Hoag’s state-of-the-art operating rooms. It will likely take
around two hours, and will be done under general or regional anesthesia.
Your inpatient stay will be from two to three days. Based on the range
of motion and stability of the implant, limited physical therapy will
begin on the first postoperative day.
Hoag’s physical therapy team will create a careful, well-planned
rehabilitation program for you to follow, as physical therapy is critical
to the success of your shoulder replacement. Most patients are able to
perform simple activities such as eating, dressing and grooming within
2 weeks after surgery. Unrestricted, active use of your arm can begin
as early as eight weeks after surgery.
About Reverse Total Shoulder Replacement
Reverse total shoulder replacement may be indicated for conditions that
include completely torn, in operable, rotator cuffs and rotator cuff tears
in association with arthritis, (a.k.a. cuff tear arthropathy.) In reverse
total shoulder replacement, the socket and metal ball are switched. This
allows the patient to use the deltoid muscle instead of the torn rotator
cuff to elevate the arm.
Hoag Orthopedic Hospital: Orthopedic Surgeons Specializing in Shoulder
& Elbow Treatment
Shoulder replacement surgery is a highly technical procedure and is best
performed by a surgical team that performs this surgery often. Hoag Orthopedic
Institute is a single specialty service center for excellence in orthopedics.
Here you will find that the surgical team has the expertise you need,
from orthopedic surgeons who specialize in leading edge shoulder and elbow
surgery, to orthopedic certified nurses and orthopedic dedicated surgical
techs and physical therapists. Your surgeon will evaluate your situation
carefully before making any decisions, and the surgical team will proceed
with your safety, pain management, and the ultimate outcome for you in
Find an Orthopedic Surgeon Specializing in Shoulder & Elbow Treatments.