Shoulder joint replacement, also called shoulder arthroplasty, is surgery to replace the bones of the shoulder with an artificial joint. The procedure is usually performed to relieve pain and restore mobility when other treatments are ineffective. However, surgery may not be recommended in some cases such as having weak rotator cuff muscles that cannot be repaired during surgery, a history of infection, unhealthy skin on the shoulder or severe mental problems.
Total shoulder joint replacement involves replacing the ball and joint socket in the shoulder with an artificial joint, or prosthesis. A metal stem with a rounded head replaces the round end of the humerus, the upper bone in the arm that fits into the socket. The socket, or glenoid, on the shoulder blade is replaced with a smooth plastic lining held in place with surgical cement. Then the joint is reconnected. A partial shoulder joint replacement, also called hemiarthroplasty, involves repair to just one of the bones.
In traditional total joint replacement, rotator cuff muscles control the replaced shoulder joint as they do in a normal joint. However, in cases involving a torn rotator cuff, this can result in a poor outcome or problems with wear and loosening over time. To address this problem the orthopedic surgeon can use reverse shoulder joint replacement surgery. In this procedure, the deltoid muscle on the top of the shoulder moves the joint.
Prognosis of Shoulder Joint Replacement
Most people can resume normal activities such as golf, swimming, tennis, bowling and other activities after surgery and rehabilitation regimen are complete. In normal use, an artificial shoulder joint may last up to 10 years, depending on the amount of stress placed on it.
Some risks to shoulder joint replacement do exist, but advances in evaluation for treatment, surgical technique and post-operative care are making these problems more rare. Complications that may occur with shoulder replacement include:
- Allergic reaction to the implant
- Loosening or breakage of the artificial joint over time
- Damage to nerves or blood vessels during surgery
- Bones breaking during the procedure or afterward
The potential of developing complications from joint replacement also depends on the underlying problem. The great majority of patients experience an excellent outcome from surgery with mild or no pain and very few need a second surgery. Wear and loosening are the most common problems which have led to improving materials used in implants.
Patients also should be aware that all surgery involves some risk including:
- Blood clots forming in the legs or lungs
- Infection which could require removal of the artificial joint
- Reactions to medications