Total Shoulder Replacement

The total shoulder replacement surgery involves the replacement of damaged shoulder joint parts with artificial joint parts called prosthesis.

Ideal candidate for total shoulder replacement surgery

• Patients with bone-on-bone osteoarthritis
• Rheumatoid arthritis
• Intact rotator cuff tendons
• Severely fractured or broken shoulder
• Limited quality of the patients life
• Failed physical therapy and analgesics treatment
• Wear and tear of shoulder joint over time
• Patients with joint dysfunction, shoulder discomfort and reduced ability to perform daily activities
• Badly damaged or torn tissues in the shoulder
• Tumor in or around the shoulder

Although above patients benefit from total shoulder replacement surgery, there are some conditions that cannot benefit from this surgery. Patients who should probably not consider a total shoulder replacement include the following:

• Individuals with depression, obesity, diabetes, Parkinsons disease
• Patients who have undergone multiple previous shoulder surgeries
• Shoulder joint infections
• Rotator cuff deficiency
• Severely altered shoulder anatomy

Procedure of total shoulder replacement surgery

The surgery is performed under general anesthesia and takes about two to three hours.

Shoulder is a ball and socket joint that is kept in place by ligaments and rotator cuff tendons. The surgery involves the replacement of a ball (upper part of the humerus) with a metal ball attached to a stem. The stem is inserted down the shaft of the humerus. Socket (glenoid) may also be replaced with a plastic piece that is usually fixed to a groove in the socket with cement.

Prognosis of total shoulder joint replacement surgery

The surgery not only gives relief to the patient from shoulder pain and stiffness but also improves the quality of life of the patient as a patient can resume his normal daily activities without much problem.

The new shoulder joint may last between 10-15 years depending upon the activity of the joint and stress placed on it.

Reverse total shoulder replacement

For some patients, who suffer from large rotator cuff tears that have led to a complex type of shoulder arthritis called “cuff tear arthropathy”, reverse total shoulder replacement is indicated.

In a reverse total shoulder replacement, the socket and metal ball are switched as compared to total shoulder replacement. In reverse procedure, the metal ball is fixed to the socket and the plastic cup is fixed to the upper end of the humerus. The replacement relies on the deltoid muscle, instead of the rotator cuff, to power and position the arm.

Candidates for Reverse total shoulder replacement

• Torn rotator cuff that cannot be repaired
• Cuff tear arthropathy
• Unsuccessful previous shoulder replacement
• Severe shoulder pain and difficulty lifting arm away from the side or over the head
• Failed other treatments