Shoulder Replacement Surgery

• Total shoulder replacement – The shoulder is a ball-and-socket joint (like your hip), a replacement typically involves replacing the “ball” atop your upper arm as well as the “socket” in your shoulder blade.
• Partial shoulder replacement – If the damaged part of the shoulder is isolated to a specific area, our surgeons may recommend a partial shoulder replacement where only the ball is replaced. This procedure is less common.
• Reverse shoulder replacement – This type of surgery is used in multiple cases where either the rotator cuff muscles are damaged beyond repair (e.g. severely deformed due to arthritis, fractures of the shoulder, etc.). In a reverse total shoulder replacement, the ball and socket positions are reversed. This alteration stabilizes or normalizes your arm’s dynamic position, so it can be more effectively powered by the deltoid and the other “power” muscles instead of the rotator cuff.

• The most common condition that patients seek shoulder replacement surgery for is osteoarthritis, which is the most common form of arthritis. It is caused by wear and tear and causes joint pain and stiffness. It is most common among older adults.
• Other conditions that shoulder replacement surgery may treat include:
  • Post-traumatic arthritis (e.g. previous fracture or dislocation)
  • Rheumatoid or other inflammatory arthritis
  • Irreparable rotator cuff tears
  • Severe acute fractures of the shoulder joint
  • Failed previous shoulder surgery

While shoulder replacement surgery is becoming more common, the treatment is typically recommended for:

• Patients who experience severe shoulder pain to the point where everyday activities are painful and difficult such as washing in the shower, reaching for something, etc.
• Patients with poor range of motion or weakness in the shoulder.
• Patients who experience significant shoulder pain while they are sleeping.
• Patients who have not responded to other treatments like physical therapy, medications, injections, or other procedures with underlying arthritis or rotator cuff tears.
• Patients who had a previous shoulder replacement that was unsuccessful. These patients may be a candidate for a reversed total shoulder replacement.

Depending on their overall health and other factors, patients could go home the same day of the surgery (outpatient) or they may require a hospital stay for overnight observation.

You will be required to wear an immobilizer to protect your shoulder, typically for four weeks following surgery including when sleeping.

All patients have a nerve block performed pre-operatively that can help your anesthesiologist minimize or avoid narcotics during your surgery. This allows you to wake up more easily and feel better immediately after surgery. In addition, the nerve block can keep your arm pain-free for 18 to30 hours, further helping you avoid post-op narcotic use.

Most shoulder replacement surgery patients experience minimal post-op pain, often requiring only non-narcotic medications.

A patient’s recovery experience is also dependent on his or her adherence to a recovery plan.
The recovery plan for shoulder replacement surgery may include:

• Physical therapy – This is usually done in-home for the first two weeks and then the patient switches to in-person physical therapy. In-person physical therapy is usually done 1-2 times weekly for 2-3 months after surgery.
• Limiting or modifying activities for the first 4-6 months post-op.