Shoulder Replacement
shoulder replacement is a highly successful procedure to reduce pain and restore mobility in patients with end-stage shoulder arthritis and, in some cases, after a severe shoulder fracture. Shoulder replacement surgery relieves pain and helps restore motion, strength and function of the shoulder.
The primary joint of the shoulder, called the glenohumeral joint, is a ball-and-socket joint in which the humeral head (at the top of the humerus, or the upper arm bone) forms the ball and the glenoid cavity (at outer edge of the scapula, or shoulder blade.) forms the socket. The ball and socket are covered with smooth cartilage to facilitate gliding motion.
In arthritis of the shoulder, this smooth cartilage degenerates, causing the the bones surfaces to come into direct contact. This increases friction, which then damages and roughens the bone, causing stiffness and pain. Surgically implanted artificial replacement surfaces restore pain-free movement, strength and function.
Types of Shoulder Replacement Surgery
The right procedure for you will depend on your age, level of activity, and the severity and type of your shoulder arthritis.
Total Shoulder Replacement Surgery
Your shoulder is a ball-and-socket joint. In this approach, the arthritic ball and socket are removed and replaced with a metal-and-plastic shoulder joint. Duke shoulder surgeons have extensive experience performing this procedure, which has been in use for more than 30 years.
Total shoulder replacement can be performed with or without a stem that fits inside the humerus bone. If you have good bone density, a stemless total shoulder can often be used.
Total shoulder replacement can be performed for osteoarthritis (the kind that develops due to wear and tear) or rheumatoid arthritis. You must have a normally functioning rotator cuff to have this surgery.
Partial Shoulder Replacement
People who want to continue very heavy lifting or who only have damage to one side of the joint may be candidates for this approach, which replaces only the ball of the joint.
Reverse Total Shoulder Replacement Surgery
If your rotator cuff is torn beyond repair and accompanied by arthritis, this may be your best option. In this approach, the ball and socket of the shoulder joint are reversed: A ball is attached where your shoulder socket normally sits, and a socket is fitted to the top of your upper arm bone. This allows you to use muscles other than the ones in the rotator cuff to move your arm.
Shoulder Revision Surgery
This may be recommended if you’ve had a previous shoulder replacement that failed, because of infection, or because the implant was incorrectly positioned or has become loose. Our shoulder surgeons’ expertise in performing this procedure is well-known. People from across the country often come to Duke for help in correcting problems from reverse total shoulder replacements or failed rotator cuff repairs.
How do I know if I need a shoulder replacement?
The most common reason for a person to have this surgery is when they have shoulder pain from arthritis that can’t be controlled with nonsurgical treatments. The pain is usually accompanied by a progressive stiffness and a grinding or grating sensation in the shoulder.
These symptoms indicate that bones that form the ball and socket of the shoulder joint are rubbing against one another because the cartilage that should lie between them has worn away.
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