Total Shoulder Replacement

If you’re experiencing chronic shoulder pain or you’re unable to extend your arm above your head fully, you may be struggling with arthritis or another shoulder complication. The team at OrthoBethesda is here to provide Bethesda, Maryland, patients with orthopedic services. Our highly qualified physicians can help you determine if you need total shoulder replacement surgery.

What Is a Total Shoulder Replacement?

Your shoulder is a highly mobile joint. The shoulder joint gives your arm full range of motion and allows it to move in various ways as you reach above your head or stretch to grab things at a distance.

This ball and socket joint is formed where the head of your upper arm bone, or humerus, meets the socket of the shoulder blade, or scapula. The socket is called the glenoid. Where these two bones meet is covered with cartilage to prevent friction as the various parts of the joint move. Synovial fluid lubricates the cartilage, and tendons and ligaments provide the shoulder with extra strength and stability.

If any of these various components become damaged, especially the cartilage, you could experience pain, stiffness or swelling. Damage to the cartilage of the joint is known as osteoarthritis.

To relieve these symptoms, your OrthoBethesda surgeon may recommend total shoulder replacement surgery. This procedure involves removing the damaged articulating parts of the shoulder joint and replacing them with artificial prosthetics.

Conditions and Symptoms Treated By Total Shoulder Replacement

When our patients have such conditions as osteoarthritis or rheumatoid arthritis, we generally advise conservative treatment options first and foremost. Examples of this may include changes in your activities, injections, medication or even physical therapy to relieve pain. However, your physician may recommend total shoulder replacement if you continue experiencing the following symptoms:

• Shoulder pain that restricts your ability to perform daily activities
• Moderate or severe pain even while resting
• Weakness
• Loss of shoulder mobility

Your Total Shoulder Replacement Procedure

When you make an appointment with one of our orthopedic surgeons, we evaluate your condition thoroughly to determine if total shoulder replacement is the right option for you. After reviewing your medical history and performing a physical examination to assess mobility and level of pain, your doctor may need additional diagnostic tests, such as MRI or X-ray.

If we decide that total shoulder replacement surgery is the best course of action, we will walk you through the procedure to ensure you fully understand what lays ahead:

1. Your total shoulder replacement surgery may be performed under regional or general anesthesia.
2. The surgeon will make an incision over the affected shoulder and separate the underlying muscle to expose the joint.
3. Depending on your condition, your surgeon may perform this procedure as open surgery or minimally invasive.
4. Open surgery involves a larger incision. Minimally invasive techniques employ an arthroscope, which is a tiny imaging camera, and surgical tools inserted through small incisions.
5. The humerus will be separated from the glenoid socket of the shoulder bone. The damaged humeral head is cut, and the bone is hollowed out then filled with cement.
6. Then, the surgeon gently fits a metal ball with an attached stem into the humerus.
7. Once the arthritic portion of the socket is prepared, a plastic glenoid component will be fixed into the shoulder bone.
8. After the prosthetic components are implanted, the underlying joint capsule is stitched up, and the wound is sutured.

Recovery After Total Shoulder Replacement

Most patients remain in the hospital for a couple of days following total shoulder replacement surgery. Your doctor will prescribe pain medications to control your pain level as well as antibiotics to prevent infection.

You can expect to have your arm secured in a sling or cast for a few weeks. Rehabilitation will begin immediately and include physical therapy to improve the strength and mobility of your shoulder. After two to six weeks, you may be able to do gentle daily activities.

A few potential risks involved with a total shoulder replacement. However, these are the same as any major surgery:

• Nausea, vomiting or dizziness due to anesthesia
• Infection
• Risk of dislocation
• Damage to muscles, nerves or blood vessels
• Continued pain
• Pulmonary embolism
• Wear and tear to the prosthetics

Further Reading

Shoulder Arthritis and Shoulder Replacement

The Ultimate Guide For Shoulder Recovery Surgery