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. 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 to evaluate the nature and extent of the problem. In many cases imaging tests such as X-rays or an MRI scan may be necessary to determine the best possible course of treatment.
The Shoulder Arthroplasty Procedure
Shoulder arthroplasty takes about 1-2 hours to perform and is usually performed with the patient under general anesthesia. It is typically performed with an incision four to six inches in length on the front (or anterior) part of the shoulder.
After the incision is 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 sometimes 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 incision closed. The patient will then spend a couple of hours in a recovery unit before being discharged home. On some occasions, patients may require an overnight stay in the hospital.
Recovery from Shoulder Arthroplasty
Prescription medications may be provided to help alleviate pain. Patients need to wear a sling for the first 6 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. Physical therapy typically starts about 6 weeks after surgery. Most patients are able to return to all of their regular activities after 3 months, though full recovery is 9 months to a year.
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 quickly after this procedure.