Total Shoulder Replacement
Total shoulder replacement is becoming an increasingly common operation for arthritis of the shoulder. Total knee replacements and total hip replacements are well known to the public. Total shoulder replacements are less known because shoulder arthritis, although prevalent, is not as crippling as arthritis of the hip and knee because you don’t have to walk on your shoulder. That being said, with baby boomers getting to the age where they are requiring more healthcare, we are seeing a tremendous increase in the number of patients with severe shoulder arthritis, which is unresponsive to conservative treatment. The same principles that provide pain relief, added motion, and enhanced lifestyle for total hip replacement and total knee replacement patients are also realized by total shoulder replacement patients.
Physical therapy and stretching are the mainstays of conservative treatment for almost all shoulder injuries before an intervention if possible. With shoulder fractures, of course, you can’t do that. For degenerative shoulder conditions, the conservative treatment methods should always be used before surgery. Home stretching, physical therapy, the use of anti-inflammatory medications and occasional steroid injections are enough to relieve the pain in many people, and preclude the need for shoulder surgery.
The best candidate would be an older patient who has degenerative shoulder arthritis, has severe pain which has been unresponsive to conservative treatment, and has retained most of their range of motion. They need to be in fair health and not have any serious fractures or previous injuries around the shoulder. Those patients do excellently.
Total shoulder replacements recover quite rapidly. In general, you have to protect the shoulder for 6-8 weeks from rigorous activity, but that does not prevent gentle, passive range of motion, doing simple activities of daily living like eating, reading, putting on clothes. You cannot do overhead lifting or heavy lifting until you’re 6-8 weeks from the shoulder replacement surgery. The total shoulder replacement itself is stable and relieves pain immediately.
Patients who are considering total shoulder replacement surgery should first be sure that they have given the non-operative treatments an adequate trial. If the pain is significant and altering their lifestyle, then they should seek an opinion from an orthopedic surgeon experienced in total shoulder surgery to consider if they are a candidate for shoulder replacement.