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.
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.