Considering shoulder joint replacement?

Damage to your shoulder often leads to two major problems: pain and limited mobility. Either issue can become disruptive enough that you ask your doctor about surgery. Recovery from shoulder surgery is not always easy — and physical therapy is part of the process — but the benefits usually outweigh the temporary setbacks. For most people, pain inside the shoulder is minimal after replacement, and nearly everyone experiences improved movement and mobility.

“My patients who have undergone a successful shoulder replacement experience excellent pain relief and significant improvement in their shoulder function,” said Dr. Derek Cuff, orthopedic surgeon with HCA Florida Healthcare. “Many patients prior to surgery have debilitating pain and limited ability to do recreational pursuits and simple daily activities.”

The basics of shoulder replacement surgery

Your shoulder is a ball-and-socket joint, which allows flexible movement in all directions. The ball-shaped top of your upper arm bone (called the humerus) connects to the cup-shaped socket in your shoulder blade (the glenoid in your scapula).

Though it sounds simple, the shoulder joint is complex. Three bones — along with different muscles, tendons and ligaments — all come together in your shoulder. This complexity often makes it difficult to pinpoint the exact cause of your shoulder pain or limited movement.

Once your orthopedic care specialist makes an accurate diagnose, they may recommend partial or complete shoulder replacement (called a shoulder arthroplasty). Partial replacement usually means the surgeon replaces the ball but not the socket it fits into.

Most people need both parts replaced. That’s because whatever caused the shoulder damage — typically arthritis or an injury — likely affects the whole shoulder.

Conditions treated with shoulder joint replacement

Shoulder replacement surgery is commonly used to treat:

• Fracture in the shoulder
• Inflammatory diseases, like rheumatoid arthritis or ankylosing spondylitis
• Osteoarthritis
• Severe tear in a rotator cuff, tendon or ligament

Candidates for joint replacement surgery

You may be a good candidate for shoulder replacement surgery if you:

• Don’t respond well to non-surgical health treatments such as injections, physical therapy or pain management medications
• Have bone-on-bone contact in the joint from major loss of cartilage
• Have severe shoulder pain, stiffness and swelling that limits daily activities and interrupts sleep

If you have severe damage to your rotator cuff or certain shoulder muscles, replacement surgery may not be the best treatment. Be sure to discuss all your options with your surgeon. Ask them the likelihood surgery would be successful for you. They will base their recommendation on factors such as your:

• Age and lifestyle
• Medical history
• Severity and cause of your shoulder damage

As with any surgery, discuss your personal risk factors with your doctor before deciding if shoulder replacement is right for you.

Reverse shoulder replacement

If you have a certain type of fracture, severe arthritis or damage to tendons around your rotator cuff, a standard replacement may not be an option. You may be a good candidate for what’s called reverse shoulder replacement.

Instead of replacing the ball with a ball and the socket with a socket, reverse shoulder replacement puts a ball on the socket side and the socket on the ball side. This reverse placement often gives the patient better strength and shoulder function.

What to expect with shoulder replacement

Shoulder joint replacement is generally safe and effective. You also may be a good candidate for advanced robotic technology to assist your surgeon during the procedure. This innovative technology allows greater precision and gives the surgeon a better view inside your body. Robot-assisted surgery may allow you quicker healing and better results.

“After surgery and completion of physical therapy, patients typically return to the activities they enjoy in a pain-free manner with improved range of motion,” said Dr. Cuff. “Modern shoulder replacements are very durable, providing long-term improvements for patients who choose surgery.”

During surgery

Surgery to replace a shoulder joint usually takes two hours or less. The surgeon will replace your natural shoulder with a prosthetic (artificial) ball and socket made from metal and plastic. Most patients only need to stay one night in the hospital, and some go home the same day.

The basic steps to the surgery include:

• Making an incision, or cut, in the skin around your shoulder
• Removing the damaged bone and cartilage
• Placing the prosthetic shoulder
• Realigning your arm and shoulder
• Closing the incision

After surgery

Your doctor will give you specific shoulder movements and exercises that are an important start to your recovery. Be sure to do these exercises as often as instructed. They allow you to begin moving your arm safely as you heal and prevent the shoulder area from stiffening up.

Plan to begin physical therapy a few weeks after your surgery. Your physical therapist will have certain shoulder stretches and other exercises for you. They build shoulder muscle strength and increase your ability to extend and move your arm in all directions.

Let us know how we can help

Recovery from shoulder replacement surgery can feel like hard work, but you’ll likely notice dramatically reduced pain inside the shoulder, less stiffness and better range of motion once you heal and adjust to your new joint.

If you’ve been suffering long enough, schedule a visit with an orthopedic specialist at HCA Florida Healthcare or ask for a referral from your primary care doctor. We can get you on the path toward pain relief and improved shoulder function.