If you are considering shoulder replacement, you probably have many questions about the surgical procedure, the preparations for surgery, the recovery, and your long-term outcome. You should consult with your orthopaedic surgeon about what to expect before and after surgery based on your specific condition. Some common concerns and questions from patients are covered here. Also visit What to Expect with shoulder replacement, for more information.
Shoulder replacement (also called shoulder arthroplasty) is a surgical procedure that replaces the damaged or worn-out “ball” and “socket” of the shoulder with implants. The procedure is done to relieve pain and restore function.
There are two types of total shoulder replacements – primary and reverse total shoulder replacement. Both procedures replace the “total” shoulder joint, meaning implants replace both the “ball” and “socket” of the shoulder joint. The procedures differ in the positioning of the ball and socket implants and the muscle groups used for movement after surgery.
Another type of shoulder replacement is a partial shoulder replacement (also called hemiarthroplasty), this type only replaces the “ball” (humeral head) of the shoulder joint, the “socket” (glenoid), is left intact.
After careful evaluation an orthopaedic surgeon, will recommend the appropriate type of shoulder replacement for you.
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Shoulder replacement surgery may be an appropriate treatment for you if you have painful, limited arm and shoulder movement that makes you unable to perform everyday tasks comfortably or sleep well at night. Patients have usually had x-ray or MRI tests showing arthritis or other chronic problems, and find they are not getting the pain relief they need from medication, injections or physical therapy. Shoulder replacement may also be indicated for people who have suffered from shoulder fractures, or when the muscles that aid the shoulder’s movement (the rotator cuff) are torn or severely damaged. An orthopaedic surgeon who specializes in shoulder surgery can best evaluate your condition and determine if a shoulder replacement is right for you.
Shoulder replacement surgery is performed in the hospital or surgical center by an experienced, specialized surgical team. The procedure generally takes 1-3 hours, although this can vary depending on the circumstances. An incision about 4-8 inches long is made in the front of the shoulder, and the ball (humeral head) is removed and the remaining bone is prepared to receive the implant. The new metal stem or nucleus is then inserted into the bone and a rounded metal head is attached. The socket (glenoid) is then smoothed and prepared, and the new plastic socket component is attached securely into place. The new ball and socket are joined together, and the incision is closed.
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Shoulder replacement surgery is typically performed on an in-patient basis (admitted to the hospital) and generally involves a hospital stay of 1-3 days; however, over the past few years the procedure has been increasingly performed on an out-patient basis at specialized surgical centers. An out-patient surgery does not require an overnight stay.
Your orthopaedic surgeon will advise you on where your shoulder replacement will be performed, which might be determined by your health insurance provider.
Most patients do not experience a dramatic change in the appearance of their shoulder or the natural contour of the shoulder. However, there will likely be a visible scar on the front of the shoulder from the incision.
There are many different types of shoulder replacement implants as well as manufacturers, the material used to make the implants will vary but they are generally made from biocompatible metal and medical grade plastic. Shoulder replacement implants have several components that together make-up the entire “joint replacement”, the various components may be made from the following materials:
In a well-documented study, 90% of shoulder replacement implants were still in place at ten years and 81% at twenty years.1 The length of time your implant lasts is highly dependent upon many factors including your age, weight, activity level, sustained injury, healing rate, infection, rotator cuff function, overall health, and other factors; natural thinning of the rotator cuff, injury to the shoulder, implant wear or loosening might occur, which could require a revision surgery.
Shoulder replacement surgery is covered by Medicare and Medicaid as well as most private insurance companies. Contact your insurance provider to determine coverage under your specific plan.
As with any major surgery, there are potential risks and complications involved during and after surgery. Some of the potential risks and complications with shoulder replacement include but are not limited to:
Your orthopaedic surgeon will carefully review with you all the potential risks and complications associated with shoulder replacement.