The upper arm bone is shaped like a ball to fit neatly into a socket created by the shoulder blade; this is referred to as the glenohumeral joint. These bones are covered by a hard cartilage, which provides a cushion between the bones when you move your arm. If the hard cartilage wears away, the bones can rub against each other to cause pain and stiffness. This is called osteoarthritis. If arthritis is limiting your everyday activities and you have not been able to manage your pain with medications, cortisone injections, or physical therapy, then a shoulder replacement might be an option for you.
Total Shoulder Replacement
A shoulder replacement (arthroplasty) is where the entire joint is replaced with metal and plastic. This procedure can be done in an inpatient or outpatient setting depending upon your health, medical history, and insurance. This means you may or may not spend a night in the hospital. The total shoulder replacement surgery involves separating the muscles in the front of your shoulder, the deltoid and pectoralis muscles, in order to access the shoulder in a nerve-free location. The rotator cuff is released to allow access to the shoulder joint. Your surgeon will replace the ball of your upper arm bone with one made out of surgical metal and replace the damaged cartilage of the socket with a surgical plastic insert. This traditional shoulder replacement surgery relies on your rotator cuff to power your shoulder in the same manner that a healthy shoulder functions.
If you have a large rotator cuff tear that is irreparable, then a traditional total shoulder replacement is not an option for you. In this case, you may have the option of replacing just the ball of the upper arm bone with an oversized ball or a reverse total shoulder replacement. In a reverse total shoulder, your surgeon will replace the ball of the upper arm bone with a rectangular plastic insert and the socket with a metal ball. After this type of surgery, your shoulder will depend on the deltoid muscles instead of the rotator cuff to power and position the arm. Both surgeries provide you with a substantial reduction in pain.
You can expect to attend physical therapy after surgery, sometimes even starting as early as the next day. Although it can take up to a year, the majority of patients who undergo total shoulder replacement surgery feel much better than they did prior to surgery. You will find that you are able to move your shoulder with greater ease and without pain, making everyday tasks enjoyable again.