20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

Total Shoulder Replacement

Osteoarthritis in the shoulder occurs when the cartilage that lines the shoulder joint wears away. Arthritis can cause many different symptoms, including stiffness, pain, and catching. In those patients who fail non-surgical management, Dr. Keller may recommend a total shoulder replacement. During shoulder replacement surgery, Dr. Keller resurfaces the degraded ends of each side of the shoulder with metal and plastic components. The goal of surgery is to provide smooth, painless shoulder range of motion. This surgery is considered very reliable; studies have revealed that most patients have a good outcome. However, shoulder replacement surgery does not last forever. Most surgeons agree that the average lifespan of a shoulder replacement is approximately 15-25 years. Therefore, in younger patients with severe arthritis, Dr. Keller may recommend a joint preserving procedure instead of a shoulder replacement.

In patients who have severe shoulder arthritis and a torn rotator cuff (rotator cuff arthropathy), Dr. Keller may recommend a special type of shoulder replacement – a “reverse shoulder replacement.” Unlike a total shoulder replacement, which relies on the rotator cuff tendons to keep the shoulder stable, a reverse shoulder replacement relies on the deltoid muscle to stabilize the shoulder. During a reverse shoulder replacement, a metal ball is placed on the socket (glenoid) and a metal/plastic socket is placed on the proximal humerus. This “reversal” changes the mechanics in the shoulder joint, allowing patients to have stable, usually painless shoulder motion without having a healthy rotator cuff.

Post-Operative Rehabilitation

Following surgery, patients are given a sling for comfort. Dr. Keller recommends intermittent icing and gentle range of motion following surgery. Dr. Keller also recommends starting physical therapy approximately 2-4 weeks after surgery. Physical therapy focuses on reducing swelling in the shoulder, restoring full range of motion, and maintaining strength in the shoulder. It is important to avoid certain shoulder positions and certain exercises during the recovery period.