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June 8, 2015
As we get older, our shoulder can have the same changes that we often see in the knee and hip. Many of us know someone who has had a hip or knee replaced, and most of these folks do quite well. A stiff, painful shoulder can keep one from doing simple tasks we take for granted. Getting dressed, combing hair, or simply carrying groceries can be impossible.
But, there is hope, as shoulder replacement surgery is a safe, reliable, and great option for those people who meet the requirements for this option. As we age, often the shoulder joint will eventually degenerate and simply wear down. The cartilage in the ball and socket joint can grind together, deform, and cause pain that is unrelenting. People will complain of loss of range of motion, inability to sleep, and worsening when the weather turns colder.
By replacing the shoulder joint, range of motion and strength in the joint is often restored to acceptable levels. Most pain is removed, and the ability to sleep again at night without discomfort is a wonderful thing. Usually the surgery takes about 90 minutes, and these artificial joints can be expected to last around 15 years. The replacement parts usually consist of a metal stem that is fitted into the upper arm bone (humerus), a metal ball that is tapped onto the stem, and depending how bad the joint is diseased a new socket can be inserted as well.
People with advanced arthritis, either osteo or rheumatoid arthritis, find themselves candidates for this procedure. Injuries that involved old fractures of the bone, or some severe traumatic fractures that cannot be fixed are often addressed with shoulder replacement surgery. Many times concurrent rotator cuff tears exist with this problem, and these can usually be repaired at the same time. Thus, people see significant pain relief and return of strength with repair of the rotator cuff.
We decide to perform this surgery usually after a good history and physical exam, along with an X-rays of the shoulder. We often see deformity of the ball and socket joint, large bone spurs, and changes consistent with chronic rotator cuff tears.
Recovery from this surgery involves immediate range of motion exercises, and hospital stays average 3-6 days. Because this is a major surgery, we usually have the patient have an extensive physical exam to make sure there are no surprises with other health concerns. Most people have no complications, and full recovery takes 4-6 months before you feel comfortable enough to go back to normal life routines.