Total Shoulder Replacement

Specialties

Total Shoulder Replacement

The shoulder is a ball-and-socket joint that allows for the successful completion of lifting, twisting, and bending motions by the arm and upper torso. This capability is enabled by strong connective tissues located at the juncture of the upper arm bone (humeral head) and shoulder blade (scapula) at the glenoid socket. Within a healthy joint, these movements will be seamless and encompass a full range of motion, as smooth cartilage provides lubrication and reduces friction.

There are a number of conditions, including degenerative wear-and-tear, which can cause the breakdown of optimal joint function. These include:

- Osteoarthritis
- Rheumatoid Arthritis
- Rotator Cuff Tears/Damage
- Osteonecrosis
- Traumatic Injury or Infection

In addition to the above, the failure or breakdown of previous replacement components may also result in the need for expert orthopaedic attention.

Symptoms and Evaluation

While there are numerous causes of shoulder damage and debilitation, the most frequently reported symptoms are common across the range of case types. If a patient suffers from any of the following, there may be a case for surgical intervention and rehabilitative care:

- Persistent aching (worsened during activity)
- Difficulty sleeping due to discomfort
- Grinding or grating sounds during joint movement
- Shoulder ‘catching’ or ‘locking’
- Difficulty completing basic activities (such as dressing or driving)

In many instances, these symptoms will be progressive in nature, increasing in severity as damage persists over time.

When determining the type and extent of injury present, Dr. Ingram will complete an in-depth examination process. Efforts will include the recording of a medical and symptom history, as well as the completion of basic strength and flexibility tests. In some cases, an MRI or x-ray may be employed in order to detect the additional presence of cartilage fragments or bone spurs.

Treatment

During initial treatment, Dr. Ingram will likely recommend the use of non-invasive methods, including anti-inflammatory drugs and at-home exercises. If these efforts do not produce the desired results, a more comprehensive approach, such as total shoulder replacement, may be required.

During a total shoulder replacement procedure, Dr. Ingram will surgically remove the damaged joint and apply a prosthesis in its place. If the surrounding bone structures are of good quality, a press-fit (or non-cemented) replacement may be used for the humeral component. However, if the bone is soft or unstable, bone cement may be applied for a stronger hold and ongoing prosthesis support. The type of glenoid component utilized will depend upon both cartilage and rotator cuff health.

Total shoulder replacement is a complex and invasive procedure that requires a high level of surgical expertise. In most cases, this operation in performed on an inpatient basis with facility release occurring 2-3 days after surgery.

Post-Op Rehabilitation

Following completion of a total shoulder replacement, it is important to follow the prescribed rehabilitative program, which likely includes a combination of prescription medications, physical therapy, and sling support. While most patients can resume regular eating and dressing habits within 2 weeks, more complex activities, such as driving or carrying groceries, may require 6-8 weeks of post-op care.

To avoid injury, a gradual approach should be taken to the rebuilding of joint strength and flexibility. Likewise, any unusual discomfort or symptoms should be reported to the orthopaedic team immediately.