Shoulder Replacement FAQ

What is shoulder replacement surgery?

Shoulder replacement surgery is most frequently used for severe degenerative joint disease (osteoarthritis) of the ball-and-socket joint. When the smooth surfaces (cartilage) become rough, they rub against each other instead of gliding as normal joints do. This causes discomfort, stiffness and swelling. Shoulder replacement can help to alleviate this pain.

There are other reasons a complete shoulder replacement may be called for, including fractures from an automobile accident or sports injury, as well as bone deformation from inflammatory arthritis

Who needs shoulder replacement surgery?

When patients have developed long-lasting pain that limits their daily activities, shoulder replacement may be the only solution. Shoulder stiffness interferes with sleep as well as the use of their arm. A shoulder replacement is performed to alleviate this pain. It also helps to restore the range of motion of the shoulder joint, which also improves shoulder function and quality of life

In most cases, arthritis and inflammation compromise the cartilage or the surrounding bone tissues. This can, in turn, cause a deformation of the bone tissues, including the ball and socket of the joint and possibly the nearby AC joint. If there is osteoarthritis present in the AC joint, a distal clavicle resection might be able to alleviate symptoms. Otherwise, for a significant problem in the ball and socket of the shoulder joint, a total shoulder replacement may be called for.

Also known as complete shoulder arthroplasty, the procedure involves removing a portion of the shoulder joint. It is then replaced by artificial implants that will restore the full range of rotation to the joint as well as significantly reducing discomfort.

What the average age range for shoulder replacement?

When the shoulder replacement is part of the treatment plan for osteoarthritis or a similar age-related degradation of the joint, the average age is between 60 to 80 years old. However, some individuals who suffered shoulder trauma from sports injuries or an automobile accident may need a shoulder replacement as early as their 40s.

Are there other treatment options?

A complete shoulder arthroplasty procedure is usually viewed as an end-stage treatment to deal with severe damage, deformity or chronic, severe joint pain. The doctors at the Orthopedic Performance Institute will only recommend it when all other avenues of treatment such as rehabilitative exercises, shoulder arthroscopy, and cortisone shots have failed to prove effective.

How is it performed?

The ball — or humeral head — of the joint is replaced with a metal ball. Titanium is one of the primary choices, as it is capable of a process known as osseointegration, when the metal fuses with living bone tissue. The end result is a stable matrix, capable of supporting the surrounding muscle

The glenoid cavity of the shoulder socket is carefully replaced with a smooth cup-like structure made from a durable type of surgical grade plastic. Metal-to-plastic creates a more fluid motion than metal on metal.

In some cases, it might only be the humeral ball of the socket that needs to be replaced. This procedure is known as Hemi Replacement or partial shoulder replacement. It’s most common in cases of trauma to the upper arm from a severe sports injury or automobile accident.

Preparing For Shoulder Replacement Surgery

The staff at the Orthopedic Performance Institute will describe your sedation options. The most common options are a local anesthesia, with interscalene block, where you may be semi-conscious or general anesthesia, where you will be fully sedated. Other preparation measures, such as abstaining from food or drink for 12 hours before the procedure, will also be described.

How long does it take to recover?

While your general health, age, and activity level are all factors, most patients will physically recover from a shoulder replacement procedure in about eight to 10 weeks. However, it may take several months up to a year before you are fully able to return to strenuous activity.

The average post-surgery stay in the hospital is a day or two, depending on recovery and need for pain management. X-rays will be taken to monitor the integrity and position of the shoulder implant. Rehabilitation specialists will also test your range of motion, and you will begin some basic physical therapy.

Are there any limitations after surgery?

Your shoulder will be immobilized in a special sling for the first week or two of the early rehabilitation phase. This allows the ligaments, tendons, and other connective tissues to heal properly. However, you will be able to remove the sling for showering and rehabilitation exercises. Your physical therapist will help you determine when you can begin relying on the sling less and less.

At six weeks, you should have almost full range of motion restored and be capable of light activities. At eight to 10 weeks you should have full active use of the shoulder and natural range of mobility. At that point, your therapist will recommend the exercises you can perform on your own to carefully restore the natural strength and range of motion.

Most patients are pain-free at around six months, though some might notice minor discomfort during this time. Patients with other physical limitations may take up to a full year to become pain-free and able to return to somewhat strenuous exercises.

What is the average success rate? 

95% of patients are pain-free and enjoy the full range of motion within nine months to a year after surgery. Once full osseointegration is achieved, and the rehabilitation phase is complete, the replacement joint should have a lifespan of 15 to 20 years.

Stop living in chronic pain. Contact the Orthopedic Performance Institute in San Antonio to see what treatment options are available to you.