We often think of our lower body when we think about joint replacement. It’s true: our knees and hips often bear the brunt of our activity as we age. However, shoulder pain can be devastating and debilitating, causing sleep disruption and interfering with daily activities. Shoulder replacement surgery is less common than knee or hip replacements. However, it provides pain relief for tens of thousands of Americans annually. But what does shoulder replacement involve, and how do you know the right time for surgery?
What Are the Signs I May Need Shoulder Replacement?
Like your hip, your shoulder is a ball and socket joint. When all is well, the “ball” at the end of your upper arm fits neatly into the shoulder socket. In a healthy joint, the surface of the bones is covered with cartilage to allow them to move smoothly and reduce friction. Muscles and tendons surround the joint to provide support. But wear and tear, arthritis and injury can cause pain and stiffness. When pain interferes with essential functions, your orthopaedist may recommend removing damaged parts of the joint and replacing them with metal and plastic implants. According to the American Academy of Orthopaedic Surgeons, signs you may want to consider shoulder replacement surgery include:
- Severe shoulder pain interferes with everyday activities, including dressing, bathroom use, bathing and eating.
- Shoulder pain prevents you from getting a good night’s sleep.
- You experience loss of motion or weakness in the shoulder.
- Other treatments like anti-inflammatory medications, cortisone injections, and physical therapy don’t work or stop working.
What Causes Shoulder Damage?
Arthritis and injury are the main reasons we consider shoulder replacement surgery. Damage to bones and cartilage can be caused by:
- Osteoarthritis (age-related “wear and tear” arthritis) damages the cartilage between the bones.
- Rotator cuff injuries involve the muscles and tendons around the shoulder joint. Loss of muscle support in the area can lead to a condition called cuff tear arthropathy, which causes damage to the cartilage.
- Fractures and other injuries: if you have a severe fracture to your upper arm, your doctor may not be able to repair the damage without a full or partial joint replacement. Improperly healed fractures can also lead to chronic pain.
- Rheumatoid arthritis and chronic inflammation can damage the cartilage.
What Are The Different Types of Shoulder Replacement Surgery?
Depending on your condition, your orthopaedist may recommend one of three types of shoulder replacement surgery:
- Total anatomic shoulder replacement replaces both the ball and socket, recreating the natural anatomy of the shoulder joint–with an artificial ball on the upper arm and a cup-like socket on the shoulder.
- Partial shoulder replacement replaces the ball of your shoulder joint. Your doctor may recommend partial replacement when the cartilage damage is limited to the upper arm portion of the joint while the shoulder socket remains intact.
- Reverse shoulder replacement is an option when your rotator cuff is severely damaged. If you have cuff tear arthropathy, your rotator cuff muscles may not provide the support needed for a traditional replacement. In a reverse shoulder replacement, the artificial ball joint attaches to the shoulder blade, and the socket replacement is attached to the upper arm bone. This procedure causes your arm to rely on the deltoid muscles on your outer arm to move, relieving pressure on the rotator cuff, improving range of motion, and reducing pain. Your orthopaedist may recommend reverse replacement if previous shoulder surgeries have been unsuccessful.
What’s The Right Age for a Shoulder Replacement?
Most shoulder replacement candidates are between 60 and 80. The good news is that joint replacement materials last longer thanks to technological advances. Most replacements last ten years or longer. If you have shoulder pain, your orthopaedist will usually try more conservative approaches first, including anti-inflammatory medications, cortisone injections and physical therapy. However, if you have severe shoulder pain that doesn’t respond to other treatments, you don’t want to wait too long and allow arthritis to become debilitating. In most cases, the benefits of shoulder surgery, including pain relief and restoration of range of motion, outweigh the risks. Before recommending shoulder replacement, your orthopaedist will review your symptoms and prior surgeries, complete a thorough physical exam and assess the joint with x-rays and CT scans.
Is Shoulder Replacement Surgery Right for Me?
Like other joint replacement surgeries, shoulder replacement is a big step. Orthopaedists don’t recommend it lightly and generally use it after more conservative approaches have been exhausted. However, shoulder replacement can be positively life-changing for patients with severe pain from joint damage. It can help make you more functional at home and work and allow you to return to the activities you love. If you’re suffering from severe pain, shoulder replacement can restore a healthy sleep routine and regain mobility and function. At Countryside Orthopaedics & Physical Therapy, our team of skilled surgeons includes shoulder expert Dr. Adam Lorenzetti. He is also vice chair of the orthopaedic department at Inova Loudoun Hospital. Dr. Lorenzetti specializes in shoulder reconstruction (including shoulder arthroscopy), anatomic and reverse shoulder replacements, and elbow surgery and reconstruction. Following surgery, our in-house physical therapy team will get you moving and on your way to a full recovery.