Shoulder Replacement Surgery

Experts at Treating Shoulder Arthritis in Orange County

What is Shoulder Replacement Surgery?

Total shoulder replacement, also known as shoulder arthroplasty, is typically used for patients suffering from shoulder arthritis that hasn’t responded well to non-surgical treatment options. Total shoulder replacement involves the removal of the arthritic shoulder joint, which are replaced with artificial metal and plastic implants to reduce pain and restore range of motion. This procedure has a 93% successful outcome rate and has far more benefit in restoring motion and reducing shoulder pain then arthroscopic shoulder surgery which has limited benefit to arthritic patients since it can only reduce pain in the mid-range of motion and not for end-range flexion, extension or rotation movements.

Anatomy of the Shoulder

The shoulder is made up of three bones; your upper arm bone (humerus), shoulder blade (scapula) and the collarbone (clavicle). The shoulder is a ball-and-socket joint where the ball of your upper arm bone fits into the shallow socket (the cup) in your shoulder blade. The socket is called the glenoid.

In a healthy shoulder, the synovial membrane, a thin, smooth tissue that covers the shoulder joint, produces a small amount of fluid that helps to lubricate the cartilage and eliminates friction in your shoulder so it moves smoothly. Over time, the cartilage that protects bones, can wear away. As the smooth cartilage surfaces disappear, the bones come into direct contact, increasing friction and causing them to roughen and damage each other.

Causes of Shoulder Arthritis

Several conditions can cause shoulder pain and decreased range of motion.

• Osteoarthritis is the wear and tear of the shoulder joint that usually occurs after age 50 and often in individuals with a family history of arthritis. The cartilage that cushions the bones of the shoulder joint softens and wears away. The bones then rub against each other, causing the shoulder joint to stiffen and become painful.
• Rheumatoid Arthritis is an inflammatory arthritis disorder where the synovial membrane becomes thickened and inflamed, producing too much synovial fluid, which overfills the joint space. This results in chronic inflammation that can damage the cartilage and eventually cause cartilage loss, pain and stiffness.
• Traumatic Arthritis can follow a serious shoulder injury. A prior fracture or severe trauma to ligaments may damage the articular cartilage over time, causing shoulder pain and limiting shoulder function.

When is Shoulder Replacement Surgery Recommended?

Our goal at Newport Orthopedic Institute is to restore motion and reduce pain so you can get back to your regular activities. Your shoulder surgeon will attempt to exhaust non-surgical treatments before recommending shoulder surgery.

Your shoulder surgeon may recommend shoulder replacement surgery if you meet the following criteria:

• Persistent and severe shoulder pain that interferes with your ability to perform daily activities
• Shoulder pain that affects your ability to sleep at night
• Loss of motion or weakness in the shoulder
• Shoulder pain that cannot be controlled with nonsurgical treatments, such as anti-inflammatories, physical therapy or cortisone injections

Pre-Op Education Class

To ensure a successful outcome we recommend that patients attend a Pre-op Total Shoulder Replacement & Reverse Total Shoulder Replacement class hosted by Hoag Orthopedic Institute. This class helps both patients and caregivers prepare for shoulder surgery and understand how best to set up your home for your recovery.

Pre-Op Planning

Your shoulder surgeon will order a CT Scan of your injured shoulder which will enable your surgeon to create a 3D template of your shoulder to perform virtual shoulder replacement surgery prior to surgery. This helps the surgeon make any necessary size adjustments to the implants that will be used to ensure the best possible fit.

What to Expect on the Day of Surgery

You will be instructed to arrive at the hospital at least 2 hours prior to surgery. The anesthesiologist will administer a nerve-block to help control post-operative pain. Surgery will take 1-2 hours. Some patients will be eligible to go home the same day as surgery, while most cases require an overnight stay for additional monitoring. For patients staying overnight at Hoag Orthopedic Institute, a physical therapist will be ordered by your shoulder surgeon to review some helpful tips for getting around post-operatively.

Recovery Timeline

• 72 Hours Post-Op: The surgical dressing will be removed. Patient will be able to shower. Typically, patients only take pain medication up to 48 hours post-operatively because most patients do not typically complain of pain after 2-3 days post operatively. In fact, on a pain scale of 1-10, most patients score a 2 or 3 within the first 72 hours. However, a shoulder sling will need to be worn for 4-6 weeks.
• Weeks 1 – 6: Your shoulder surgeon will assign some self-directed, gentle exercises to be performed. The patient will stop using the sling at week 6.
• Weeks 6-12: Your shoulder surgeon will prescribe formal physical therapy to further assist you gain your range of motion and strength.
• 4 Months: Most patients feel 80% recovered at 4 months post-operatively

Schedule a consultation with a Newport Orthopedic Institute orthopedic shoulder surgeon in Orange County to treat your shoulder pain.
Call (949) 722-7038.