TOTAL SHOULDER REPLACEMENT
Anatomy of the Shoulder
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 (head of the humerus) 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. The surrounding muscles and tendons provide stability and support.
Why would I need a Total Shoulder replacement?
Unfortunately, conditions such as:
- Osteoarthritis (degenerative joint disease)
- Rheumatoid arthritis
- Traumatic injury
- Failed previous shoulder replacement surgery
can lead to loss of the cartilage and mechanical deterioration of the shoulder joint. The result can be pain. You can have a stiff shoulder that grinds or clunks. This can lead to a loss of strength, decreased range of motion in the shoulder and impaired function. There is conservative treatments available to slow down arthritic damage and help live with the pain. A total joint replacement is considered when all other methods of treatment have failed to offer relief to the extent needed to live life with a functioning shoulder.
Symptoms that lead to a total shoulder replacement
Patients with arthritis typically describe a deep ache within the shoulder joint. Initially, the pain feels worse with movement and activity, and eases with rest. As the arthritis progresses, the pain may occur even when you rest. By the time a patient sees a physician for the shoulder pain, he or she often has pain at night. This pain may be severe enough to prevent a good night’s sleep. The patient’s shoulder may make grinding or grating noises when moved. Or the shoulder may catch, grab, clunk or lock up. Over time, the patient may notice loss of motion and/or weakness in the affected shoulder. Simple daily activities like reaching into a cupboard, dressing, toileting and washing the opposite armpit may become increasingly difficult.
Shoulder replacement surgery
During a shoulder replacement the ball shaped head of the humerus is precisely cut away and portions of the internal cavity of the bone are removed. A press fit piece of hardware is inserted into the humerus and an artificial ball is attached to the anchoring hardware. The socket in the shoulder is cleaned up of any bone spurs and the site is prepped for installation of an artificial socket prosthesis. The joint is tested before closing the surgical site. Recovery from a shoulder replacement is significant with a healing period and rehabilitation period. Most patients recover enough to resume exercise by month three and are generally pain free by month six.