Joel Hurt, MD
Board Certified Orthopedic Surgeon
Shoulder replacement is the third most common joint replacement procedure performed in the United States. It can give you pain-free movement again, but there are a few different approaches to this surgery to consider. Our providers can correctly diagnose your shoulder pain and explain all of your joint replacement options.
As shoulder arthritis progresses, the joint surfaces become more rough and the joint loses range of motion. In some cases there can be severe bone erosion. All of this leads to the symptoms of pain and dysfunction.
Shoulder replacement is a procedure in which the missing and damaged cartilage is replaced with special plastic (polyethylene) and metal components. Together, these implants recreate smooth articulating surfaces that ultimately reduce, if not eliminate, the symptoms of shoulder arthritis.
In a shoulder arthroscopy, your provider creates a tiny incision in your shoulder. Through this incision, they will place an arthroscope – a thin, lighted tube containing a small camera – that sends images to a monitor that is then used to view the inside of your shoulder joint.
Arthroscopies are used to diagnose problems and determine the extent of damage. Even MRI’s will understate the problem at times, but direct visualization rarely does.
While your shoulder isn’t a weight-bearing joint, shoulder replacement is still a major decision. That means it’s vital that you discuss your thoughts, needs, and goals with your provider. Austin Orthopedic Institute wants to help you be as active and pain-free as possible.
Generally, shoulder replacement is only recommended to patients who:
In addition to treating simple arthritis, shoulder replacement is also very commonly used to treat massive rotator cuff tears in the elderly, humerus fractures, and finally shoulders with severe bone erosion. Which type of shoulder replacement you get depends on what the primary issue is.
In a partial shoulder replacement, the head of the humerus (the ball part of the ball-and-socket) is restored using a new metal surface. The socket part of the joint is retained.
Partial shoulder replacement may be a good option if you have a non-healing fracture, are young with early onset arthritis, or have a special condition called avascular necrosis of the humerus (in which the bone tissue dies and collapses).
With total shoulder replacement, also known as anatomic shoulder replacement, both the humeral head and cartilage are restored. This type of shoulder replacement more closely mimics your normal anatomy when compared with reverse shoulder replacement. A normal rotator cuff and bone erosion that is no more than mild to moderate are pre requirements to be a candidate.
While very effective at improving symptoms, it’s important to know that a total shoulder replacement has limitations. It’s not designed for heavy weight lifting or sports. Lifestyle should be pared back to simple daily activities in order to help the replacement last as long as possible.
Reverse shoulder replacement is the most common shoulder replacement procedure. With reverse shoulder replacement, the positions of the ball-and-socket joint are swapped in order to improve shoulder joint mechanics and improve function. This is generally very useful for some types of humerus fractures, as well as irreparable rotator cuff tears when the mechanics of the shoulder are not working properly.
For instance, some patients with large rotator cuff tears who previously could not lift up their arm (a condition called pseudoparalysis) can often regain full range of motion, reasonable strength, and no pain post-op after a reverse shoulder arthroplasty.