The upper arm bone is shaped like a ball to fit neatly into a socket created by the shoulder blade; this is the glenohumeral joint. These bones are covered by a hard cartilage, which cushions the bones when you move your arm. If the hard cartilage wears away, the bones can rub against each other, causing pain and stiffness. This is called osteoarthritis.
If arthritis is limiting your everyday activities and you haven’t been able to manage your pain with medications, cortisone injections, or physical therapy, a shoulder replacement might be an option.
Total Shoulder Replacement
In a shoulder replacement (arthroplasty) the entire joint is replaced with metal and plastic. This procedure can be done in an inpatient or outpatient setting depending upon your health, medical history, and insurance. This means you may or may not spend a night in the hospital.
Total shoulder replacement surgery involves separating the deltoid and pectoralis muscles in the front of your shoulder to access the shoulder in a nerve-free location. The rotator cuff is released to access the shoulder joint.
Your surgeon will replace the ball of your upper arm bone with one made of surgical metal and replace the damaged socket cartilage with a surgical plastic insert. This traditional shoulder-replacement surgery relies on your rotator cuff to power your shoulder in the same manner that a healthy shoulder functions.
If you have a large, irreparable rotator-cuff tear, you may be able to replace just the ball of the upper arm bone with an oversized ball or undergo a reverse total shoulder replacement, where the ball of the upper arm bone is replaced with a rectangular plastic insert and the socket with a metal ball. After this type of surgery your shoulder will depend on the deltoid muscles instead of the rotator cuff to power and position the arm. Both surgeries provide substantial pain reduction.
You can expect to attend physical therapy after surgery, sometimes even the next day. Although it can take up to a year, the majority of patients who undergo total shoulder replacement surgery feel much better. You will find that you are able to move your shoulder with greater ease and without pain, making everyday tasks enjoyable again.