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.

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Rheumatoid arthritis is a disease that affects your joints. It causes pain, swelling and stiffness. If joints on one side of your body have rheumatoid arthritis, usually the joints on the other side do too. It can affect any joint in the body. Rheumatoid arthritis can also make you feel sick and tired, and sometimes get fevers.

What’s the difference between rheumatoid arthritis and osteoarthritis (OA)?

RA is an autoimmune disorder that produces inflammatory joint symptoms throughout the body. OA is a degenerative condition that is the result of increased wear and tear on joints. OA may produce inflammatory symptoms as well, but it primarily destroys joint cartilage over time.

Both RA and OA are more prevalent in women than in men. RA can develop in patients aged 30 to 60 at any time. OA generally develops later in life. Courses of treatment can also vary.

What are the symptoms of rheumatoid arthritis?

Symptoms can range from mild to severe, including:

• Tender, warm and swollen joints
• Swollen joints on both sides of the body, such as your hands and wrists
• Swelling in other joints, including the neck, shoulders, elbows, hip, knees, ankles and feet
• A feeling of weariness and low energy
• Fever
• Pain and stillness lasting more than 30 minutes in the morning
• Symptoms that go on for years

What causes RA?

Doctors don’t know the exact cause, but they have identified several factors, The immune system normally attacks invaders to the body, such as a cold virus or bacteria, but with this type of arthritis, a person’s immune system attacks his or her own body tissues. Researchers are learning many things about why and how this happens.

Other causes of RA may include:

• Inherited genes
• Environmental factors
• Hormones

Is there a test for RA?

There is no single specific test. It can be difficult to diagnose because the symptoms are often the same as other kinds of joint disease and can take time to fully develop. Doctors use medical history, a physical exam, x-rays, imaging tests and lab tests to make a diagnosis.

How is RA treated?

Fortunately, physicians have many ways to treat the disease, including medications, surgery, regular check-ups and complementary therapies.

Most people with RA take medications to relieve pain, reduce swelling and to stop the disease from getting worse. What a doctor prescribes depends on:

• Your general healh
• How serious the disease is
• How serious it will become
• How long you will take the drug and how well it will work
• Possible side-effects

Depending upon the severity of the disease, surgery may be recommended. It can help to:

• Reduce pain
• Help your joint work more effectively
• Help you to resume your daily activities

Regular medical check-ups are essential in order for your doctor to:

• See if the disease is worsening
• Monitor the effectiveness of the medications
• Check for adverse side-effects
• Change treatment as necessary

Complementary therapies include special diets, vitamins and behavioral changes such as weight loss and joint care.

“Here are OPI we use a multi-disciplinary team approach to treating rheumatoid arthritis,” says Dr. Alexandra S. Matthews. “Often we work with rheumatologists, physical therapists and other health care providers to ensure maximal improvement in pain and quality of life.”

If you have any of the symptoms described above, contact Orthopedic Performance Institute today.

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What is osteoarthritis?

Osteoarthritis is the most prevalent form of arthritis, afflicting 30.8 million adults in the United States.

Osteoarthritis is a disease that damages the slippery tissue that covers the ends of bones in a joint. This allows the bones to rub together. The rubbing causes pain, swelling and loss of motion of the joint. Over time, the joint may lose its normal shape.

The condition can cause bone spurs to grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space, which causes more pain and damage. Unlike some other forms of arthritis, osteoarthritis affects only joints and not internal organs.

Who can get it?

Osteoarthritis occurs most often in older people. Younger people sometimes get the disease after joint injuries.

What are the symptoms?

Osteoarthritis can occur in any joint, but it occurs most often in the hands, knees, hips and spine. Warning signs are:

• Stiffness in a joint after getting out of bed or sitting for a long time.
• Swelling or tenderness in one or more joints.
• A crunching feeling or the sound of bone rubbing on bone.

What causes osteoarthritis?

Osteoarthritis usually happens gradually over time. Some things that might make it more likely include:

• Being overweight
• Getting older
• Joint injury
• Joints that are not properly formed
• A genetic defect in joint cartilage
• Stresses on the joints from certain jobs and playing sports

Is there a test for the condition?

Most doctors use several methods to diagnose the disease and rule out other problems:

• Ask you about your medical and family history.
• Give you a physical exam.
• X-rays of the bone or images of the soft tissues in the joint.
• Other tests such as blood tests or examination of the fluid in the joints.

How is it treated?

There are many treatments that can help relieve pain and help you live with osteoarthritis. You should talk to your doctor about the best treatments for you, which can include:

• Medicines
• Non-drug pain relief techniques
• Complementary and alternative therapies
• Surgery

“Today there are many surgical and non-surgical options to decrease or stop arthritic pain,” said Orthopedic Performance Institute’s Dr. Alexandra S. Matthews. “We individualize treatment plans, based on our patient’s concerns, needs and comfort levels. We also use a holistic approach, discussing nutrition and exercise as well as medical interventions.”

If you are feeling any of the symptoms of osteoarthritis, catching it early is crucial. Contact Orthopedic Performance Institute in San Antonio for an appointment today.

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