Shoulder Arthroplasty

In some cases, a patient may be told they need a shoulder replacement. Believe it or not, there are a number of different replacement options for each unique patient situation. For the purpose of this discussion we will focus on a Total Shoulder Arthroplasty (TSA), more commonly recognized as a shoulder replacement. We’ll quickly review the anatomy of the shoulder to better understand what parts of the shoulder are involved in a TSA.

The shoulder, or glenohumeral joint, is a ball-and-socket joint that consists of the humerus (ball), clavicle (collarbone) and scapula (shoulder blade). As you re-read the previous sentence, you’ll notice that the socket is not specifically mentioned. The socket component of the shoulder is a shallow grove in the shoulder blade called the glenoid. The humerus is larger than the glenoid so the muscles surrounding the joint, such as the rotator cuff, work together with the labrum (lining tissue of the glenoid) to help stabilize the ball in the socket. Now that we’ve reviewed some of the anatomy, we’ll discuss the reasons for which a patient may need a shoulder replacement.

Each patient and their situation are different, so a replacement is not for everyone. Criteria for surgery include: failed non-operative treatment, severe pain, stiffness, and loss of motion due to osteoarthritis. Complex shoulder or humerus fractures could lead to a patient needed a shoulder replacement as well.

Shoulder Arthroplasty 1The procedure itself is performed under regional anesthesia (interscalene nerve block – for more information please ask for our handout in the office) in conjunction with sedation so the patient will be asleep for the procedure. Sedation should not be confused with general anesthesia. A TSA generally takes 1 ½ to 2 hours to complete but could be longer depending on the shoulder. The prosthesis is made up of the humeral and glenoid components. The humeral component Dr. Ahmad typically uses is made up of cobalt chromium-based alloys or titanium. The glenoid component is made of high-density polyethylene (plastic).

The patient should expect to spend up to two days in the hospital post-operatively, although most patients are discharged the day after surgery. In the post-operative period, the patient can expect to be in their sling for 4-6 weeks. However, physical therapy typically starts immediately after discharge from the hospital. Shoulder Arthroplasty 2For example, if surgery is on Friday then physical therapy should begin the following Monday. If our rehab protocol is followed, range of motion is nearly restored six weeks after surgery and significant improvements are seen around the 4 to 6 month mark. Within one year from surgery the patient should be near complete recovery!

A shoulder replacement is a detailed surgery and comes with a recovery that deserves much attention. Let Team Ahmad be the team to help you through your surgery and get you back to the activities you enjoy!

View our Shoulder Replacement Brochure (PDF) »

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© 2018 Christopher S. Ahmad, MD

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