Shoulder Replacement Surgery
Shoulder replacement, also known as shoulder arthroplasty, is a surgical procedure in which the damaged or diseased shoulder joint is replaced with an artificial joint, known as a prosthesis or implant. The procedure is typically performed to relieve severe pain and restore function in the shoulder joint when non-surgical treatments have not been effective.
This is an open operation requiring an incision in the shoulder to access the joint. The damaged parts of the shoulder joint, including the ball-shaped head of the upper arm bone (humerus) and the shoulder socket (glenoid), are removed. The prosthesis is then implanted to replace these components.
There are different types of shoulder replacement implants, including:
- Anatomic Shoulder Replacement: In this procedure, both the ball and the socket of the shoulder joint are replaced with artificial components.
- Reverse Shoulder Replacement: This procedure is performed when there are significant rotator cuff tears or muscle dysfunction. The ball and socket components are reversed, with the ball portion attached to the scapula (shoulder blade) and the socket portion attached to the upper arm bone.
- Partial Shoulder Replacement: Also known as hemiarthroplasty, only the ball-shaped head of the humerus is replaced, while the natural socket is preserved.
Reverse Shoulder Replacement
The most common type of shoulder replacement. The joint is reversed by replacing the humerus with a socket and the glenoid with a ball.
Anatomic Shoulder Replacement
This replacement is done when the rotator cuff muscles are intact. The glenoid is resurfaced with a plastic and the humerus is replaced with an implant.
Reverse Shoulder Replacement
In Australia, 65% of all shoulder replacements are reverse replacements. The concept of reversing the ball and socket of the shoulder switches the biomechanics of the shoulder around. This is done to treat any underlying muscle tears and to recruit the deltoid muscle (the muscle that forms to contour of your shoulder). With a reverse shoulder replacement, the centre of rotation is shifted, which allows the deltoid muscle to maintain stability of the shoulder and to allow range of motion.
Longevity of Shoulder Replacement
The longevity of a shoulder replacement depends on multiple factors and is an important factor when considering a shoulder replacement. In Australia, every joint replacements is recorded and tracked over time. Shoulder replacements have been shown to have reliable results for 10-15 years after surgery.
Recovery after a shoulder replacement is variable from patient to patient. Below is a guide of what to expect after surgery. Your recovery time-frame may be different. Dr. Arthur Turow will discuss your particular circumstances and the recovery time-frames with you.
Most shoulder patients have a nerve block after surgery, which covers pain for 12-36 hours. Once the block wears off, your nurse will start you on pain medication to keep you comfortable. You will need to stay in hospital for 2-3 days after surgery. A physician and physiotherapist will typically review you after your surgery and will guide you through your recovery phases.
First two Weeks
- You will be in a sling during this time
- The focus during this time is pain and swelling management as well as wound care
- A follow-up appointment will be made for you at 2-3 weeks after surgery
- You should be able to resume most daily activities
- Your sling is usually weaned after six weeks
- Your physiotherapist will start working on increasing your range of motion and strength
- You will start on reconditioning your shoulder by strengthening your muscles and increasing movement
- Most of your pain should have settled by now
- Your range of motion will continue to improve
- You will see incremental increases in strength and range of motion
- Your maximal range of motion will be reached by 12months after surgery, but may still continue to improve up to 18 months after surgery
Please use above information as a guide only. More detailed information specific to your condition and your recovery will be given in your consultation with Dr. Arthur Turow, who will also provide additional resources to supplement your discussion. For more information, please contact the rooms of Dr. Arthur Turow on (08) 8236 4179.