Shoulder Joint Replacement

Are You a Candidate for Shoulder Replacement Surgery?

Shoulder replacement is less common than hip or knee replacement, but equally as effective in relieving joint pain. The shoulder is actually composed of four joints and provides greater range of motion than any other joint in your body. It is made up of three bones held together by tendons and ligaments: the humerus (upper arm bone), clavicle (collarbone), and scapula (shoulder blade).

The humerus and scapula form the main shoulder joint, the glenohumeral joint, which is similar to a ball-and-socket joint. The top of the humerus is round and it glides in a shallow socket in the scapula called the glenoid.

Like all joints, the shoulder joints are lined with articular cartilage, which facilitates smooth movement of the bones. Age and injury can lead to the deterioration of cartilage and onset of osteoarthritis. Over time, the shoulder becomes stiff and painful. If arthritis becomes so severe that you can’t lift or rotate your arm anymore, your doctor may recommend shoulder replacement surgery.

While arthritis is one of the most common reasons for shoulder replacement, other problems can result in the need to replace the joint, as well. Injuries such as a complex shoulder fracture or severe rotator cuff tear may require shoulder joint replacement to reduce pain and restore motion. Fractures can interrupt the blood supply to the bone, while a rotator cuff tear can damage cartilage and cause arthritis (a condition known as rotator cuff arthropathy).

The symptoms of shoulder arthritis progressively get worse. It typically starts with a deep ache in the shoulder when it moves but goes away when you rest it. Eventually, the pain becomes constant and is present even when you rest or sleep. Your shoulder may become weak and lose range of motion, like the ability to reach.

At the Center for Orthopaedic Surgery and Sports Medicine in San Antonio, our joint replacement surgeons will start with a conservative treatment, such as medication, cortisone injections, and physical therapy, to relieve your pain. When these do not provide pain relief anymore, your doctor will likely recommend shoulder joint replacement.

There are two main surgical approaches for shoulder replacement: total shoulder replacement and reverse shoulder replacement.

Total Shoulder Replacement Surgery

Total shoulder arthroplasty is the most common type. It is typically recommended for those who have osteoarthritis without a rotator cuff tear. After your surgeon makes an incision on the front of your shoulder, he will replace the damaged head of the humerus with a metal ball and replace the glenoid with a plastic socket.

If your glenoid is not damaged, the surgeon may opt to replace only the damaged head of the humerus. This procedure, called a hemiarthroplasty, is commonly used to treat shoulder fractures.

Reverse Shoulder Replacement

This type of shoulder replacement is best for those with a complete rotator cuff tear, severe arthritis with rotator cuff damage, or failed shoulder surgery. The procedure involves reversing the placement of the shoulder implants: the metal ball is affixed to the shoulder blade with screws, while the socket prosthesis is attached to the humerus using a special bone cement.

How does the reverse shoulder replacement work? The rotator cuff is responsible for lifting and rotating the arm, so when it is damaged, it cannot function properly. Traditional total shoulder replacement would still leave these patients with pain and the inability to lift their arms above their shoulders. Switching the placement of the ball and socket allows the deltoid muscles on the outer shoulder, instead of the damaged rotator cuff, to lift the arm above the shoulder.

If you are experiencing chronic shoulder pain, schedule an appointment with one of the doctors at the Center for Orthopaedic Surgery and Sports Medicine to find out if you are a candidate for shoulder joint replacement. Call (210) 692-7400 today or use our online form.