Shoulder Joint Replacement

OrthoTeam Clinic

Board Certified Orthopedic Surgeons & Sports Medicine located in Madison, WI & Stoughton, WI

The shoulder is a highly movable body joint that allows various movements of the arm. It is a ball and socket joint, where the head of the humerus (upper arm bone) moves with the socket of the scapula (shoulder blade) called the glenoid. The two bony surfaces are covered with cartilage, which acts as a cushion between the moving bones. The cartilage is lubricated by synovial fluid. Tendons and ligaments around the shoulder joint provide strength and stability to the joint.

When the cartilage is damaged, the two bones rub against each other resulting in pain, swelling, and stiffness of the joint (osteoarthritis).

Total shoulder replacement surgery is performed to relieve these symptoms. In this surgery, the damaged parts of the shoulder joint are removed and replaced with artificial implants. Replacement of both the humeral head and the socket is a total shoulder replacement.

Who is a Candidate for Shoulder Joint Replacement?

Total shoulder joint replacement surgery is indicated for conditions such as osteoarthritis or rheumatoid arthritis when medication, injections, physical therapy, and activity changes do not help relieve pain. Your doctor recommends surgery when you have the following symptoms:

Severe shoulder pain that restricts daily activities
Moderate to severe pain during rest
Weakness and/or loss of motion

Diagnosis

To decide whether total shoulder replacement is a good option for you the surgeon will evaluate your condition thoroughly.

Your surgeon reviews your medical history and performs a physical examination of your shoulder to assess the extent of mobility and pain. Imaging tests such as X-ray or MRI (magnetic resonance imaging) may be ordered.

Replacement Options

Your surgeon will perform either a primary total shoulder replacement or a reversed total shoulder replacement. Both procedures replace the “total” shoulder joint, meaning implants replace both the “ball” and “socket” of the shoulder joint.

Patient Education Brochure

Total or Partial Shoulder Replacement

Patients with an intact rotator cuff and painful shoulder arthritis would be candidates for a total shoulder replacement or a partial shoulder replacement, as determined by your surgeon.

Reverse Shoulder Replacement

Patients who have a torn rotator cuff and painful shoulder arthritis may benefit from a reverse total shoulder replacement. The implant reverses the shoulder's normal structure and uses the strength of the deltoid muscle to move the arm.

Procedure

With a CT image of the patient’s shoulder, the surgeon uses 3D computer technology to map out each patient's surgery before the patient comes to the hospital. The surgery is done under general anesthesia. An incision is made over the affected shoulder and the underlying muscles are separated to expose the shoulder joint. The upper arm bone (humerus) is separated from the socket of the shoulder bone. The arthritic or damaged humeral head is cut.

Next, the arthritic part of the socket is prepared. A metal ball is either placed on the top of the arm bone or within the socket. A new socket component may be fixed in the shoulder bone or arm bone, if appropriate. After the artificial components are implanted, the joint capsule and/or the rotator cuff are stitched back together, and the wound is closed.

Post Operative Care

After the surgery, medications are prescribed to control pain. Your arm will be secured in a sling. The rehabilitation program includes physical therapy, soon after the surgery, and is very important to strengthen and provide mobility to the shoulder. You may be able to perform gentle daily activities two to six weeks after surgery.