Shoulder replacement surgery may be required if there is significant damage to the shoulder joint caused by advanced arthritis or complex fractures, and non-surgical treatments have been unsuccessful or more limited keyhole or open surgery is ineffective.
Replacing whole or part of your shoulder joint may be required in situations where a more limited keyhole or open surgery is ineffective.
This might be the case in advanced osteoarthritis, complex fractures in which fixing the bone pieces back in place is not feasible, or where the muscles and tendons around the shoulder are too damaged to be stitched back into place. Other conditions which can damage the shoulder joint are Rheumatoid arthritis, post-traumatic arthritis, rotator cuff tears, Avascular Necrosis, or previously failed shoulder replacement surgery.
During shoulder replacement surgery, the damaged parts of the joint are replaced with artificial components, called a prosthesis. There are three broad types of shoulder replacement:
• Shoulder Hemi Arthroplasty, where only the ball of the shoulder joint is replaced, either with a prosthesis with a long stem into the arm bone or one without the stem.
• Total Shoulder Arthroplasty, where the ball as well as the socket is replaced with a metal and plastic one.
• Reverse Polarity Shoulder Replacement, where the ball and socket of the shoulder joint is replaced with a metal and plastic device, with the artificial metal ball attached to the shoulder blade and the socket attached to the arm bone.
If a replacement surgery were required, Mr George-Malal will carefully explain the pros and cons of each approach and help guide you to make the right choice.
Who is an ideal candidate for shoulder replacement surgery?
If there is too much damage to the bones, muscles or tendons in the shoulder, and alternative treatments have failed to treat the following conditions, then shoulder replacement surgery may be recommended:
• You are experiencing severe pain in the shoulder
• Pain is interfering with your ability to perform everyday activities
• You experience pain even at rest which disturbs your sleep
• Loss of mobility and a sensation of weakness in the shoulder
If you decide to proceed, Mr George-Malal will assess your fitness for surgery. You must advise him of any pre-existing medical conditions or prescription medications you are taking. You’ll be given instructions on how best to prepare for surgery and the recovery period and you’ll be advised to quit all nicotine products in advance of your operation if you do smoke.
What happens during shoulder replacement surgery?
A shoulder replacement procedure usually takes one to two hours and is performed under a general anaesthetic and nerve block. An incision is typically made at the front of the shoulder and through the soft tissues to access the joint. Any damaged parts of the joint are removed, and artificial components implanted. The incision is then closed with stitches or staples.
What is the recovery like after a shoulder replacement?
You will usually return home after an overnight stay. Recovery varies depending on the individual and the extent of the procedure.
It usually takes a few weeks to return to light, daily activities, but you may still need support in getting dressed or household chores. Most patients get immediate relief from arthritic pain. An exercise programme will be advised to help you rebuild your shoulder strength, range of motion, and flexibility.
