Severe shoulder conditions with persistent symptoms that have not responded to conservative treatments may benefit from shoulder arthroplasty, or shoulder joint replacement surgery. Shoulder arthroplasty is a procedure in which the damaged joint is replaced with an artificial joint that allows patients to enjoy painless motion and resume their regular activities. Joint replacement of the shoulder is not performed as frequently as that of the hip or knee, but it is equally effective in improving a patient’s comfort and use of the affected arm.
Reasons for Shoulder Arthroplasty
Prolonged pain in the shoulder and other symptoms can be effectively relieved by replacing the damaged bone and cartilage with a metal and plastic implant. Similar to the hip, the shoulder is a ball-and-socket joint that can be significantly improved with joint replacement surgery. Shoulder arthroplasty is often performed to treat conditions such as:
- Rheumatoid arthritis
- Rotator cuff tears
Patients with severe cases of these conditions typically experience pain, limited range of motion, stiffness, swelling and other uncomfortable symptoms. A doctor will take a medical history and perform a physical examination in order to evaluate the nature and extent of the problem. In many cases imaging tests such as X-rays or an MRI or bone scan may be necessary to determine the best possible course of treatment.
The Shoulder Arthroplasty Procedure
Shoulder arthroplasty takes about two hours to perform and is usually performed with the patient under general anesthesia. It may be performed arthroscopically using very small incisions and a tiny camera and surgical tools or through a traditional open procedure that requires an incision four to six inches in length.
In either method, after the incisions are made the surgeon will remove the damaged portions of the bone and cartilage within the shoulder. This generally includes the head of the humerus, or upper arm, bone and the glenoid, which forms the socket. The surfaces of the remaining bone are then smoothed and prosthetic devices are positioned in the space and attached with surgical cement. In some cases, the metal ball with a stem that is used to replace the ball of the humerus may be able to be fitted to the bone and not require cementing if the existing bone is strong enough. Once the artificial joint is securely in place in the shoulder, the surgeon can suture the incisions closed. The patient will then spend several hours in a recovery unit before being transferred to a hospital room.
Recovery from Shoulder Arthroplasty
Patients are typically required to stay in the hospital for one to three days following the procedure. Prescription medications may be provided to alleviate any pain and prevent post-surgery infection. Patients need to wear a sling for the first several weeks to provide adequate protection and support to the healing shoulder. Physical therapy is also an important part of the recovery process as it is an effective way to restore flexibility and function to the joint after surgery. Most patients are able to return to all of their regular activities after two to three months.
Risks of Shoulder Arthroplasty
While shoulder arthroplasty is considered a safe and effective procedure, there are certain risks involved with any surgical procedure. These risks may include infection, blood clots, nerve injury, instability and loosening of the implant. These risks are considered rare, and most patients experience symptom relief and improved range of motion after this procedure.