Shoulder Replacement
Shoulder replacement surgery is a safe and effective procedure to restore comfort and eliminate motion restrictions, and disability caused by:
- End stage osteoarthritis (wear and tear arthritis) that destroys the cartilage that cushions the bones, causing the bones to rub together, resulting in significant pain and disability. End stage arthritis pain is the primary indication of the need for a total shoulder replacement.
- Rheumatoid arthritis that affects the joint and causes cartilage loss, pain, and stiffness.
- Post traumatic arthritis following a severe shoulder injury.
- Rotator cuff tears that lead to arthritis which destroys the joint cartilage.
Recovery from a shoulder replacement requires the patient’s commitment to proper and extensive post-op rehab to achieve the full benefits from this surgery.
What are the types of shoulder replacement surgery?
Shoulder replacement (Arthroplasty) will be recommended when arthritis affects the glenohumeral joint (the ball and socket joint), it is advanced, and the patient has persistent pain and dysfunction. It involves replacement of both the ball and the socket with prosthetic components.
There are several options for shoulder replacement:
This procedure replaces the damaged ball and socket with prosthetic components made of metal and plastic. The goal of shoulder arthroplasty is to relieve pain and restore motion, strength and function. This is an open surgical procedure involving a small incision along the front of the shoulder and the upper arm.
Anatomic shoulder replacement is the gold standard shoulder replacement procedure for patients with an intact rotator cuff and sufficient glenoid bone to accommodate the implants. This procedure is offers reliable pain relief, implant longevity and a low incidence of complications.
At six months most patients are pain-free and have a return of near full motion and strength. At one year, eighty-five percent or more of patients will be pain free and without strength or motion limitations. The remaining 15% of patients will have improvements in pain and motion compared to their arthritic state.
This is a newer procedure that provides total shoulder replacement as an outpatient procedure. Only short incisions are needed, and there is no moving or cutting of the rotator cuff and muscles. Because there is no damage to the rotator cuff, there are no activity restrictions and recovery is faster, about three months. Other benefits include same day surgery versus several days in the hospital which decreases costs, decreased risk of infection, less blood loss, minimal damage to soft tissues, less pain, fewer complications, reduced recovery time and faster return to recreational activities.
For patients who are not ideal candidates for an anatomic total shoulder, because of high physical demands and for those with poor glenoid socket bone other procedures such as a hemiarthroplasty or a reverse shoulder arthroplasty may be recommended.
This is the procedure to replace only the ball of the joint. The original socket is maintained. This is often used for young active patients and avoids complete removal and replacement of the humerus head. This procedure may also be indicated for patients with a severe fracture of the head of the upper arm bone.
Reverse shoulder is recommended to treat rotator cuff arthropathy, a condition where the rotator cuff is severely damaged combined with arthritis. It may also be indicated for patients with bone loss, a severe fracture of the upper arm bone, or for patients with a previous replacement that has failed. Other indications for reverse shoulder have been widely expanded.
A reverse technique offers stability and does not rely on the rotator cuff tendons. The deltoid muscle is used to move the shoulder instead of the rotator cuff. Thus, this approach is perfect when the damaged shoulder needs new surfaces, but there is not enough healthy tissue to stabilize and move the shoulder.
Similar to an anatomic total shoulder replacement, both the ball and socket are replaced. However, in this approach, the implants are reversed. They are placed opposite of where they are naturally located. This means that the ball is attached to the shoulder blade, while the socket is attached to the humerus. 10-year survival without revision over 90%, and 15-year survival rate of 85%.
Schedule a shoulder consultation
At Silicon Valley Orthopedics we strive for compassionate, personalized care and treatment options geared to your needs. Contact Silicon Valley Orthopedics to schedule a consultation to learn more. We have offices in Fremont, Los Gatos and Menlo Park for your convenience.
