Shoulder replacement surgery

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Also called shoulder arthroplasty.

The humeral head and glenoid bone are replaced with metal and plastic components to alleviate pain and improve function of the joint.

The procedure is performed after more conservative treatments have failed.

An elective surgery.

93% survivorship of the prosthesis at 10 years and 87% at 15 years.

Relief from moderate or severe pain was in 83% of procedures with an average follow-up of 12.2 years.

Results indicate the ability to raise the arm to the side improves by an average of 40 degrees to an average of 117 degrees.

There has been a dramatic increase in the number of shoulder arthroplasties performed.

This increase is the result of an aging population , and increasingly more active population, better implant technology, and the advent of reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy.

The indications for reverse shoulder arthroplasty have expanded to include pathologies such as rotator cuff insufficiency, chronic instabilities, trauma, and tumors.

Reverse shoulder arthroplasty is surgery used to replace a damaged shoulder joint.

The procedure differs from standard shoulder replacement surgery because it switches the shoulder’s normal ball-and-socket structure around to allow for more stability in the joint after surgery.

Reverse shoulder arthroplasty is particularly useful for people like you who have a damaged rotator cuff along with shoulder arthritis, and can effectively reduce pain and increase shoulder mobility.

In some cases, torn rotator cuff tendons can be surgically repaired. But when they are severely damaged, especially if arthritis also affects the joint, reverse shoulder arthroplasty may be a better treatment choice.

During reverse shoulder arthroplasty, that ball-and-socket mechanism is reversed.

A surgeon attaches an artificial ball to the shoulder blade, and an artificial socket is attached to the top of the arm bone.

The new socket is fitted against the new ball to allow smooth movement.

The tissue is sewn together around the joint, and the incision is closed.

After such surgery, the large deltoid muscle that covers the shoulder typically is able to move the arm.

The surgery usually takes one to two hours and requires an overnight hospital stay.

The results from reverse shoulder arthroplasty usually are quite good. In approximately 90 percent of cases, people who have this surgery experience significant pain relief, and their ability to move their arm increases substantially.

The results of most arthroplasties are good.

Glenoid and/or humeral bone deficiencies can have detrimental effects on the clinical outcomes of these procedures.

Bone loss becomes more of a problem in revision cases.

Many patients with primary osteoarthritis have significant glenoid bone deformity.

Humeral bone loss is seen in proximal humerus fractures, in revision surgery necessitating humeral component removal, and, less commonly, in tumors and infection.

In many displaced proximal humeral fractures indicated for shoulder arthroplasty, the bone is comminuted with displacement of the lesser and greater tuberosities.

In many displaced proximal humeral fractures failure of tuberosity healing may result in loss of rotator cuff function with loss of elevation, rotation, and even instability.

Humeral shortening can also occur as a result of bone loss and can compromise deltoid function.

Humeral shortening with metaphyseal bone loss can adversely affect long-term fixation of the humeral component, leading to stem loosening or failure.

Humeral bone loss can also result from humeral stem component removal in revision shoulder arthroplasty for infection, component failure or loosening, and even periprosthetic fracture resulting from surgery or trauma.

Humeral bone loss creates a complex set of circumstances related to rotator cuff attachment failure, soft-tissue balancing effects, and component fixation issues.

Glenoid component placement with durable fixation is crucial for success in anatomical total shoulder arthroplasty and reverse shoulder arthroplasty.

Glenoid bone deformity and loss can result from intrinsic deformity characteristics seen in primary osteoarthritis, cuff tear arthropathy, or glenoid component removal in revision situations and infection.