Shoulder replacement surgery

Shoulder replacement surgery

Shoulder replacement is joint replacement surgery to treat conditions such as arthritis of the shoulder, rotator cuff tear and fracture of the shoulder blade. These conditions can cause severe shoulder pain, hinder the normal range of motion and affect your daily activities and sleep. Shoulder replacement surgery is often recommended if other nonsurgical treatments or surgeries have failed and the patient continues to experience severe symptoms.

According to the Agency for Healthcare Research and Quality, about 53,000 people in the United States have shoulder replacement surgery each year. 

Anatomy of the shoulder

Your shoulder is a large joint comprised of three bones: the humerus (upper arm bone), scapula (shoulder blade) and clavicle (collar bone). The shoulder is best described as a “ball and socket” joint, because the head of the upper arm bone (humerus) fits into the shallow socket (glenoid) of the shoulder blade.

The surfaces of the bones that connect in the shoulder blade are covered in smooth soft-tissue material called articular cartilage. This cartilage creates protection for the bones while allowing them to move easily within the socket. The substance which covers the remaining surfaces inside the shoulder joint is referred to as synovial membrane. The synovial membrane is thin, smooth tissue that creates fluid and lubricates the articular cartilage in the joint. The lubrication eliminates any friction in the shoulder due to movement.

The muscles and tendons surrounding the shoulder provide stability and support for its vast range of motion. When any part of this structure is damaged, it can immobilize the shoulder joint and cause the need for shoulder replacement surgery.

About the surgery

For shoulder replacement surgery you will be given either general or regional anesthesia to keep you pain free during the procedure. General anesthesia puts you to sleep for the entire procedure. Regional anesthesia won’t put you to sleep, but will numb your arm and shoulder area during the surgery. You will most likely be given a sedative to keep you relaxed during the process.

Your orthopaedic surgeon will recommend one of two types of shoulder replacement surgery, depending on the extent of damage in your shoulder:

  • Total joint replacement – The surgeon begins the procedure with an incision over the shoulder joint. The damaged end of the humerus bone is removed, then replaced with an artificial stem topped with a round, metal head. The surgeon uses bone cement to hold the artificial humerus head in place. The surgeon will then smooth the surface of the old socket and cover it with a smooth, plastic shell. The artificial socket replacement is cemented onto the old socket.
  • Partial joint replacement – During this procedure only one of the two bones of the shoulder joint is replaced.

While you're in the hospital, a physical therapist will teach you light exercises to prevent your injured shoulder from getting stiff during the healing process. You will be required to wear a sling during your recovery time in the weeks after the procedure. Many people who undergo shoulder replacement surgery are able to go back to their daily activities without pain or stiffness in their shoulder.

The multidisciplinary team of shoulder experts at Northwell Health Orthopaedic Institute performs shoulder replacement surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the shoulder and elbow joints.

Animated video: Total shoulder replacement

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