Total shoulder joint replacement is an option for patients experiencing joint dysfunction. The decreased function and resulting pain is most often caused by arthritis. Osteoarthritis, rheumatoid arthritis, rotator cuff arthropathy, and trauma related arthritis are the four most common sources of shoulder joint destruction. When conservative methods of treatment (oral medications, injections and physical therapy) fail to provide adequate relief, shoulder replacement is considered.
The primary purpose of shoulder joint replacement is to relieve pain. Many patients will also experience an increase in range of motion. Shoulder replacement has an extremely successful track record with survival of implants over 90% at 17 years and has transformed the lives of many patients.
The type of shoulder replacement depends upon the particular patient pathology. Partial shoulder replacements may be indicated in young individuals with disease limited to the humerus. Complete shoulder replacement is the most common procedure and delivers better overall results for a patient with disease affecting both the humerus and glenoid. A relatively new procedure, reverse shoulder replacement, switches the component positions of the humerus and glenoid. This transition allows for tensioning of the deltoid in patients with severe rotator cuff deficiency associated with arthritis, a condition which previously had no treatment solution.
Total shoulder replacement typically requires a two hour procedure and may be accomplished under regional anesthesia. Blood transfusion requirement after shoulder replacements is approximately 1%. The average hospital stay after surgery is 24-48 hours. Patients are progressed through a series of exercise after surgery and may be unrestricted in activity by 12 weeks post surgery. Although much of the strength and range of motion of the shoulder will return within 3 months post surgery, improvement will be seen over the first postoperative year.