Shoulder Replacement

What is shoulder replacement surgery?

The shoulder is a ball and socket joint. The round end of the arm bone fits into the opening at the end of the shoulder blade, called the socket. This type of joint allows you to move your arm in most directions.

For total shoulder replacement, the round end of your arm bone will be replaced with an artificial stem that has a rounded metal head (ball). The socket part (glenoid) of your shoulder blade will be replaced with a smooth plastic lining that will be held in place with special cement. If only 1 of these 2 bones needs to be replaced, the surgery is called a partial shoulder replacement, or a hemiarthroplasty.

The surgery is done in the following way:

• Your surgeon will make an incision (cut) over your shoulder joint to open up the area.
• The surgeon removes the head (top) of your upper arm bone (humerus)
• The new metal head and stem is cemented into place
• The surface of the old socket is smoothed and the new socket is cemented in place
• The incision is closed with staples or sutures
• Dressings (bandages) are placed over your wound
• Your surgeon may place a tube in this area to drain fluid that may build up in the joint. The drain will be removed when you no longer need it.
• This surgery normally takes 1 to 3 hours.

Some patients may need a different type of procedure called reverse total shoulder replacement. In this surgery, the positions of the ball and socket are switched. The round part of the shoulder is removed from the top of the arm, and a metal ball is attached to the shoulder blade. The socket is then attached to the arm bone. The ball ends up on the other side of the shoulder. This surgery can be done when the rotator cuff tendons are severely damaged or there are fractures of the shoulder.

Why is the procedure performed?

Shoulder replacement surgery is usually done if the shoulder joint is badly damaged and you have pain or cannot use your arm. Some causes of damage are:

• Osteoarthritis
• Rheumatoid arthritis
• Poor outcome from past shoulder surgery
• Badly broken bone
• Badly damaged or torn tissues in the shoulder
• Tumor in or around the shoulder
• Stiff shoulder

What to expect before, during, and after shoulder surgery?