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Shoulder Replacement: Symptoms and Treatments

May 1, 2019

Having joint and shoulder pain is difficult to deal with every day.

If shoulder pain causes disruption from allowing you to have a great quality of life, and non-surgical options are not helping you overcome this pain, shoulder replacement surgery is worth considering.

Are you a candidate for total shoulder replacement? Read on to learn more.

WHAT IS A SHOULDER REPLACEMENT SURGERY

Total shoulder replacement, also known as total shoulder arthroplasty (TSA), treats the pain and stiffness in the shoulder to remove arthritis or joint disease in the shoulder.

The primary goal of shoulder replacement surgery is to relieve pain, as well as to restore motion, strength and function of the shoulder so that the patient may return to an activity level that is as normal as possible.

WHO IS A CANDIDATE?

  • Patients with arthritis.
  • Patients who want to have the best chance of a return to function.
  • Patients who have failed conservative treatment.

SYMPTOMS

  • Loss of motion or weakness in the shoulder.
  • Severe shoulder pain that interferes with everyday life.
  • Moderate to severe pain at rest (or difficulty sleeping).

DIAGNOSING CANDIDATES

  1. Arthritis that cannot be controlled through non-operative treatments, such as anti-inflammatory medications, injections, or rest. This is the most common indication.
  2. X-rays showing significant arthritis (loss of joint space) of the shoulder joint.
  3. Conducting a CT scan or an MRI test may be necessary.

TREATMENT

There are different types of shoulder replacement options available. Talk with your physician to see which is the best choice for you.

  • Total Shoulder Arthroplasty: This surgical option replaces the arthritic joint surface with a metal ball attached to a stem and a plastic socket.
  • Reverse Total Shoulder Replacement: A metal ball will be attached to the shoulder socket, and a plastic socket is attached to the upper arm bone. This allows the patient to use their deltoid muscle to lift their arm. This surgical option may be necessary for patients with previous shoulder replacement failure and loss of rotator cuff function.
  • Stemmed Hemiarthroplasty: In this surgical option, the head of the humerus is replaced with a metal ball and stem. Patients with a severely fractured humeral head but normal socket may undergo this type of surgery.
  • Resurfacing Hemiarthroplasty: This surgery involves replacing just the joint surface of the humeral head with a cap-like prosthesis.

HOW TO PREPARE FOR SURGERY

To best be prepared, the patient should be in the best physical and mental health at the time of surgery.

  • Steer clear of any infection. This will delay your surgery.
  • Any skin problems, such as rashes, acne or scratches on the shoulder should be resolved before the surgery.
  • Make sure the surgeon is aware of all health issues.
  • The day before the surgery do not eat or drink anything after midnight.
  • Medical issues may cause a delay in your surgery.

PROCEDURE

The shoulder replacement surgery involves replacing the ends of bones in a damaged joint. Overall, this surgery creates new joint surfaces that will provide less pain and better mobility. The procedure takes about one to three hours to complete.

The surgeon separates the deltoid and pectoral muscles to access the shoulder in a nerve-free area. The shoulder joint is accessed by cutting one of the (front) rotator cuff tendons. This allows the surgeon to view arthritic parts of the shoulder and ball socket.

After the arthritic sections are removed, the new components are inserted, and the shoulder joint, including the rotator cuff, is closed. A sling and sterile dressing are applied. Then, the surgeon stitches and cleans the incision.

RECOVERY FROM SURGERY

  1. Upon surgery being completed, you will be given medication to ease the discomfort of the pain. Most patients have minimal pain after total shoulder replacement and may stay in the hospital one night.
  2. Patients find that they have more mobility of their shoulder. Physical therapy is key here! Additionally, a patient will have to wear a sling for two to four weeks upon departure from the hospital. Providers suggest that performing home exercises often will help gain strength in the shoulder faster.
  3. Due to newer implant technology, it is estimated from experts that shoulder replacements have very good longevity, and revision surgery is rarely needed. This may differ for younger patients due to activity level.

A short timeline for recovery of surgery goes as follows:

  • Two months after surgery: motion is about half normal, but there is a small bit of weakness.
  • Four months after surgery: most patients are pain-free. Motion and strength are two-thirds normal. As a warning, the shoulder will not move as far as it did prior to  arthritis.
  • Six months after surgery: 95 percent of patients are pain-free. The other five percent have an occasional ache with excessive activity or a weather ache.

COMPLICATIONS

With any surgery, there is always a risk of complications occurring. Some of these include:

  • Pain and stiffness
  • Infection
  • Nerve injury
  • Fracture or dislocation of the upper arm bone
  • Problems with wound healing

Shoulder replacement surgery is a safe and effective procedure for helping people with shoulder pain. If you want to resume your everyday lifestyle and activities without pain, or you believe you may be a candidate for this procedure, talk to your doctor today.

MOUNTAINSTATE ORTHOPEDIC ASSOCIATES | SHOULDER REPLACEMENT SURGERY

Mountainstate Orthopedic Associates is one of the regions leading orthopedic practices. Our goal is to get patients back to doing the activities they love without joint pain.

We have been providing quality joint care to our patients since 1977. Don’t let joint pain stop you from doing the things you enjoy.

Give us a call at 304-599-0720, or click below to learn more about joint pain:

Read our guide to shoulder pain.