An anatomic total shoulder replacement is an option for patients with severe arthritis of the shoulder. This may also be a solution for patients who have suffered a severe fracture or who not achieved pain relief from non-operative treatments.
During the procedure, the ball (humeral head) of the shoulder joint is replaced with an implant that includes a stem (that inserts into the center of the bone in your arm) with a smooth, rounded metal head. The socket (glenoid) is replaced with a smooth, rounded plastic cup that fits the rounded metal head.
In cases where there is severe damage to the ball yet the socket is normal, the surgeon may replace only the ball. As with any joint replacement surgery, a rehabilitation program including physical therapy and home exercises are key to a successful recovery.
Following is a video that shows a general demonstration of the shoulder joint replacement procedure. Your surgery may vary depending on your individual condition.
DEMONSTRATION OF ANATOMIC SHOUDER REPLACEMENT PROCEDURE
REVERSE SHOULDER REPLACEMENT
In certain cases, the rotator cuff tendons may be severely degenerated or torn beyond repair. If the patient has a drastic loss of mobility and severe pain, a reverse shoulder replacement may be performed. This procedure is called a “reverse” because the implants reverse the ball and socket of the shoulder joint. This alters the mechanics of the shoulder to allow the stronger deltoid muscle to take over shoulder strength and function.
Reverse total shoulder replacement may be recommended for patients with:
- Completely torn or irreparable rotator cuff tendons
- Shoulder arthritis with a large rotator cuff tear
- Severe shoulder fracture
- Shoulder dislocation and a large rotator cuff tear
In rare instances, only the ball portion of the joint is replaced. This is called hemiarthroplasty. The
same ball and stem are used as in traditional total shoulder replacement. However, the socket is not replaced by a
polyethylene liner. This surgery is usually reserved for very young patients, those with intact cartilage on the socket,
or those who do not have enough bone on the socket to accept a replacement. Evidence shows that the recovery
from hemiarthroplasty is more difficult than total shoulder replacement, and improvement is unpredictable. Total
shoulder replacement provides more reliable pain relief and function compared to hemiarthroplasty.
During shoulder replacement surgery, it is routine for one of the biceps tendons to be moved out of the way so it does not cause pain afterwards. This will not cause any physical deformity or decrease in strength or function.