A complete shoulder replacement procedure is usually needed to address advanced issues from arthritis or complications from a severe shoulder fracture. The goal is to replace the mobility and relative function of the joint, while also helping to alleviate pain or discomfort. This also improves the overall quality of life for the patient, as well as letting them eventually return to light duty physical activities.
What Causes The Need For Shoulder Replacement Surgery?
In most cases, arthritis and inflammation compromise the cartilage or the surrounding bone tissues. This can in turn cause a deformation of the bone tissues, including the ball and socket of the joint and possibly the nearby AC joint. In the case of osteoarthritis in the AC joint a distal clavicle resection might be able to alleviate symptoms. For a significant problem in the ball and socket of the shoulder joint, a total shoulder placement surgery may be needed.
Also known as complete shoulder arthroplasty, the procedure calls for removing a modest portion of the shoulder joint. It is then replaced by artificial implants that will eventually restore the full range of rotation as well as significantly reduce discomfort in the joint.
Though other things can lead to a need for a complete shoulder replacement. This includes severe fractures from an automobile accident or sports injury, as well as bone deformation from inflammatory arthritis.
What Is The Average Age For A Shoulder Replacement?
For cases where the shoulder replacement is part of the treatment plan for osteoarthritis or a similar age-related degradation of the joint, the average patient age is between 60 to 80 years old. Though some individuals who suffered shoulder trauma from sports injuries or an automobile accident who may need a shoulder replacement as early as their 40s.
Are There Alternative Treatments?
A complete shoulder arthroplasty procedure is usually an end-stage treatment to deal with severe damage, deformation, or chronic, severe joint pain. A physician will only recommend it when all other avenues of treatment such as rehabilitative exercises, shoulder arthroscopy, and cortisone shots have failed to produce the desired results.
How Is The Shoulder Replacement Performed?
During a complete shoulder replacement, the compromised ball or humeral head of the joint is essentially replaced with a metal ball. Titanium is one of the primary choices, as it is capable of a process known as osseointegration where the metal gradually fuses with living bone tissue. The end result is an incredibly stable matrix capable of supporting the surrounding muscles.
Then the glenoid cavity of the shoulder socket is carefully replaced with a smooth cup-like structure made from a special, durable type of surgical grade plastic. The metal-to-plastic relationship of this type of joint replacement creates a more fluid motion than metal on metal.
Though in some cases, it might only be the humeral ball of the socket that needs to be replaced. This procedure is known as Hemi Replacement or partial shoulder replacement. It’s more common in cases of trauma to the upper arm from a severe sports injury or automobile accident.
Preparing For Shoulder Replacement Surgery
Your physician will help you understand your sedation options. The most common options are a local anesthesia, with interscalene block, where you may be semi-conscious or general anesthesia, where you will put fully sedated. Your physician will then explain other preparation measures such as abstaining from food or drink for 12-hours before the procedure.
Once you are comfortable the surgeon will start by carefully separating the deltoid and pectoral muscles to gain direct access to the shoulder. They will then open the shoulder joint by carefully cutting one of the front muscles in the rotator cuff.
At that point, the affected bone tissues and cartilage of the joint are removed. The artificial implant socket, ball, and other critical components are inserted. The artificial ball component is then secured attached to the humerus.
The rotator cuff muscle is then closed and all affected soft tissues are stitched. The skin is then cleaned and stitched and a sterile bandage is applied to help cover the wound.
How Long Does It Take To Recover After Shoulder Replacement Surgery?
While your general health, age, and activity level are all factors, most patients will physically recover from a shoulder replacement procedure in about 8 to 10 weeks. Though it may take several months up to a year before you are fully capable of strenuous activity.
You will likely need to stay in the hospital for a day or two after the operation. X-rays will be taken to assess the integrity and position of the shoulder implant. Rehabilitation specialists will also test your range of motion, and you will start some basic physical therapy.
Are There Any Limitations After Shoulder Replacement Surgery?
Your shoulder will need to be immobilized in a special sling for the first week or two of the early rehabilitation phase. This will allow the ligaments, tendons, and other connective tissues to heal properly You can remove the sling for showering and rehabilitation exercises. Your physical therapist will help you determine when you can start to use the sling less.
At 6 weeks, you should have near full range of motion restored and be capable of light activities. At 8 to 10 weeks you should have full active use of the shoulder and natural range of mobility. At that point, your physical therapist will advise you on exercises you can perform on your own to gradually restore the natural strength and range of motion.
Most patients are pain-free at around 6 months, though some might notice minor discomfort for up to six months. Patients with other physical limitations may take up to a full year to become pain-free and able to return to somewhat strenuous exercises.
What Is The Average Success Rate After Shoulder Replacement Surgery?
95% of patients are pain-free and enjoy the full range of motion within 9 months to a year after shoulder replacement surgery. Once full osseointegration is achieved, and the rehabilitation phase is complete, the replacement joint should have a lifespan of 15 to 20 years.