Total Shoulder Replacement

Total shoulder replacement is a surgical procedure indicated to relieve pain and restore function in severely damaged shoulder joints. This procedure has become increasingly common, offering patients significant improvements in their quality of life.

What is Total Shoulder Replacement?

Total shoulder replacement, also known as shoulder arthroplasty, involves replacing the damaged ball-and-socket parts of the shoulder joint with prosthetic implants. The shoulder joint comprises the humeral head (ball) and the glenoid (socket). During the procedure, the surgeon removes the damaged bone and cartilage, replacing them with metal and plastic components to mimic the natural function of the shoulder.

Who needs Total Shoulder Replacement?

– Persistent pain and stiffness: Continuous discomfort and restricted shoulder movement despite conservative treatments.

– Significant limitation in range of motion: Severe restrictions in shoulder mobility impacting daily activities.

– Post-traumatic arthritis: Joint damage from previous injuries leading to chronic pain and instability.

– Severe joint damage: Significant injuries resulting in impaired shoulder function that non-surgical methods cannot rectify.

– Failure of non-surgical treatments: Physical therapy, medications, and corticosteroid injections do not alleviate symptoms adequately.

– Persistent pain: Continuous pain despite exhaustive non-surgical treatment options necessitates considering shoulder replacement.

– Functional impairment: Difficulty performing routine tasks due to chronic shoulder pain, significantly affecting quality of life.

– Reduced quality of life: Ongoing pain and limited shoulder function severely impact daily living and overall well-being.

– Complex fractures: Severe shoulder fractures that compromise the integrity of the joint and cannot be effectively treated with other methods.

– Non-healing fractures: Fractures that do not heal properly, resulting in chronic pain and dysfunction.

– Avascular necrosis: Bone death due to interrupted blood supply leading to severe shoulder joint destruction.

– Rotator cuff tear arthropathy: Joint damage due to chronic rotator cuff tears causing pain and loss of shoulder function.

What are the symptoms indicating the need for Shoulder Replacement?

– Persistent shoulder pain that does not respond to medications or physical therapy.

– Difficulty performing everyday activities due to shoulder pain or limited motion.

– Night pain that prevents sleeping on the affected side.

– Weakness or instability in the shoulder joint.

– Grinding or clicking sounds in the shoulder during movement.

How is Total Shoulder Replacement performed?

During the total shoulder replacement surgery, the patient is placed under general anesthesia. The surgeon makes an incision on the front or side of the shoulder to access the joint. The damaged humeral head is removed and replaced with a metal ball attached to a stem, which is inserted into the humerus. Next, the damaged cartilage and bone from the glenoid cavity are removed, and a plastic socket is fitted into place. The new ball and socket components are then aligned to ensure smooth movement and stability. The incision is closed with sutures, and the shoulder is bandaged. The entire procedure typically lasts between two to three hours, depending on the complexity of the case. Following surgery, the patient is moved to a recovery area where they are monitored as the anesthesia wears off.

What types of shoulder implants are used?

– Standard Implants: Metal ball with a plastic socket.

– Reverse Shoulder Implants: Used for patients with severe rotator cuff tears; the ball is placed on the shoulder blade, and the socket is placed on the arm bone.

– Partial Implants: Only the damaged part of the shoulder is replaced, often used when the glenoid is healthy.

– Custom Implants: Designed specifically for the patient’s anatomy, used in complex cases.

What is the recovery process after surgery?

Recovery from total shoulder replacement surgery involves several stages. Initially, the patient will spend a few days in the hospital for monitoring and pain management. Physical therapy begins almost immediately to prevent stiffness and maintain range of motion. The arm will be in a sling for several weeks to allow healing. Gradually, the intensity of physical therapy will increase to strengthen the shoulder muscles and improve mobility. Most patients can return to light activities within 3 to 4 months, but full recovery may take up to a year.

What are the risks and complications associated with the surgery?

– Infection at the surgical site.
– Nerve or blood vessel damage.
– Dislocation of the shoulder joint.
– Loosening or wear of the implant over time.
– Blood clots.
– Adverse reactions to anesthesia.
– Persistent pain or stiffness.
– Need for revision surgery.

How long does the Shoulder Replacement last?

A total shoulder replacement typically lasts between 15 to 20 years, but this can vary depending on factors such as the patient’s activity level, the type of implant used, and adherence to post-surgical care and rehabilitation. Advances in implant technology and surgical techniques continue to improve the longevity of shoulder replacements.

What can you expect from rehabilitation and physical therapy?

Rehabilitation is a crucial part of the recovery process. Initially, physical therapy focuses on gentle exercises to maintain flexibility and prevent stiffness. As healing progresses, therapy will include more active range-of-motion exercises and strengthening activities. The goal is to restore as much function as possible and to help the patient return to their daily activities. Regular follow-ups with the surgeon and therapist are essential to monitor progress and make any necessary adjustments to the rehabilitation plan.

How should you prepare for Shoulder Replacement Surgery?

Preparing for shoulder replacement surgery involves several steps:

– Medical Evaluation: Undergo a thorough medical assessment to ensure you are fit for surgery.

– Preoperative Tests: Complete any required blood tests, X-rays, or other diagnostic tests.

– Medications: Discuss any medications you are taking with your doctor; some may need to be adjusted or stopped before surgery.

What lifestyle changes are recommended post-surgery?

After shoulder replacement surgery, certain lifestyle changes can enhance recovery and extend the life of the implant:

– Avoid High-Impact Activities: Refrain from activities that put excessive strain on the shoulder, such as heavy lifting or contact sports.

– Maintain a Healthy Weight: Reducing strain on the joints by managing weight can help improve outcomes.

– Adhere to Rehabilitation Protocols: Follow your physical therapy plan diligently to regain strength and mobility.

– Modify Daily Activities: Use ergonomic tools and modify tasks to reduce shoulder strain.

What is the success rate of Total Shoulder Replacement?

Total shoulder replacement has a high success rate, with approximately 90% of patients experiencing significant pain relief and improved function. Advances in surgical techniques and implant materials continue to enhance outcomes, making it a reliable option for those with severe shoulder joint issues.

What are the benefits of Total Shoulder Replacement?

– Significant pain relief.
– Improved range of motion.
– Enhanced ability to perform daily activities.
– Increased shoulder strength.
– Better sleep quality due to reduced pain.
– Improved overall quality of life.
– Long-lasting results with modern implants.
– High patient satisfaction rates.
– Potential to return to low-impact recreational activities.
– Decreased reliance on pain medications.

Total shoulder replacement is a life-changing procedure for many individuals suffering from severe shoulder pain and dysfunction. By understanding the process, risks, and benefits, patients can make informed decisions and actively participate in their recovery journey. Dr. Ponnanna is a best orthopedic surgeon specializing in total shoulder replacement in Bengaluru with extensive expertise in restoring shoulder function and alleviating pain.

Book your appointment today to benefit from his skilled care and personalized treatment approach for optimal shoulder health and mobility.