A painful, immobile shoulder can make it difficult to perform daily tasks and prevent you from enjoying activities you once loved. The pain may be persistent, keeping you from enjoying a full night of sleep and impacting your overall quality of life. While some individuals find relief from shoulder pain with analgesics and simple exercises, others require surgical treatment to reduce the discomfort and restore range of motion in this joint.
Shoulder replacement has been used for decades to treat shoulder conditions that no longer respond to traditional therapies like medication and exercise. As many as 53,000 shoulder replacements are performed in the U.S. each year, according to the American Academy of Orthopaedic Surgeons. While that does not compare with the 900,000 knee and hip replacements that are done annually, plenty of adults are finding significant relief and restoration of their daily routines through shoulder replacement surgery.
When it is healthy, the shoulder allows for greater range of motion than any other joint in the body. It consists of the top of the upper arm bone, known as the humerus, the scapula or shoulder blade and the clavicle or collar bone. The upper head of the humerus fits into the socket of your shoulder blade via a socket called the glenoid. Articular cartilage covers the bony areas to offer protection and smooth range of motion. A membrane covers the remainder of the bony surfaces and produces a small amount of fluid to keep the cartilage lubricated.
Over time, the joint cartilage can become damaged through normal wear and tear, or be caused via injury or trauma. This damage allows the bone to grind against bone, leading to pain and reduced mobility. Injury can also occur to the shoulder, particularly tears of the tendons, ligaments or rotator cuff. Fractures are another injury that could necessitate a shoulder replacement if the bone is too shattered or damaged to rebuild.
Your surgeon will perform your shoulder replacement under general anesthesia, and will most likely utilize a nerve block as well. The nerve block uses local anesthesia that numbs your entire shoulder and arm from the neck down. The nerve block reduces the need for general anesthesia by about 50% and helps control post-operative pain. The surgeon will make an incision between the shoulder and chest muscle and then separate the two, so the components of the artificial joint can be put in their proper place.
The shoulder prosthesis consists of a metal stem that has a ball on one end and a socket composed of heavy-duty, biocompatible plastic. The stem is placed into the top of the humerus and is usually cemented in to make it more stable. The socket is cemented into the scapula. The tendons of the shoulder are used to hold the ball into place in the socket. In a reverse total shoulder arthroscopy the ball and socket are flipped to restore strength when rotator cuff tears are identified.
You will spend one to two days in the hospital to receive attentive care. You will be given medication to reduce your discomfort and a sling to protect your shoulder. The sling is worn for two to six weeks, although it can be removed for bathing and physical therapy.
You will begin supervised physical therapy within seven to 10 days after your surgery, which will last for three months. You will also need to do the exercises at home to alleviate stiffness and restore range of motion to the joint. With rehabilitation, you may find you can resume many activities you were unable to do before your replacement surgery.
While the full results of shoulder replacement are not entirely predictable, the rate of patient satisfaction after this surgery is overall very high. Most of our patients enjoy pain-free movement of the joint within one year after surgery, which increases their mobility and their quality of life. To learn more about your options in shoulder replacement, contact the Orthopaedic Institute of Ohio today at 419-222-6622.