Although not as often discussed as hip or knee replacements, shoulder replacement surgery is a fairly common procedure in the world of modern orthopedics. In fact, more than 50,000 individuals in the United States now undergo shoulder replacement surgery each year, more than double the approximate annual average of 18,000 as of the year 2000. This dramatic increase stands as a testament to the enhanced quality of life experienced by many shoulder replacement patients, as well as the expedited recovery process now possible thanks to improvements in surgical techniques.
Shoulder replacement surgery isn’t just for older adults suffering from chronic conditions such as shoulder osteoarthritis. It’s also a common treatment option for younger, active adults and athletes. Not only do athletes turn to replacement surgery to relieve pain from shoulder problems, but most are able to continue their careers with the help of the procedure. According to a recent study by the Academy of Orthopaedic Surgeons (AAOS), nearly 97 percent of athletes 55 and under returned to one sport or more about seven months following shoulder replacement surgery.
Sadly, many individuals endure osteoarthritis shoulder pain, discomfort, and limited range of motion for years before choosing to undergo surgery. Fortunately, for those who do pursue treatment, there are many surgical options designed to help patients live the active, pain-free lifestyle of their dreams. In this post, we will different types of shoulder replacement surgery, shoulder replacement recovery, physdiscussical therapy after shoulder replacement, and more.
Before we get to the surgical procedures, an anatomy lesson is in order. The shoulder, like the hip, is a ball and socket joint. In total, the shoulder joint is made up of three bones: the clavicle (collar bone), the scapula (shoulder blade), and the humerus (upper arm bone). Articular cartilage acts as a buffer between the surfaces of these bones, allowing the joint to move smoothly. The rounded upper portion of the humerus fits within a small socket in the scapula known as the glenoid. A series of ligaments, muscles, and tendons surround these bones to support the joint.
There are many reasons why an individual may elect to have shoulder replacement surgery, including severe arthritis of the joint, a torn rotator cuff, or an acute shoulder injury, such as a complete fracture. If pain and discomfort in the joint have not responded adequately to shoulder physical therapy, medications, injections, and other nonsurgical options, your doctor may recommend shoulder replacement surgery (also known as shoulder arthroplasty). Those suffering from severe osteoarthritis shoulder pain in particular may benefit greatly from shoulder replacement surgery. Before suggesting surgical options, your doctor will first evaluate the joint, which will typically involve a physical examination and the use of diagnostic imaging to better understand the underlying condition and level of joint damage.
So what is shoulder replacement surgery? The term actually refers to several separate but related procedures, and the one recommended by your provider will depend on the nature and severity of your condition. The main varieties of shoulder replacement surgery are total shoulder replacement surgery, partial shoulder replacement surgery, and the most recently developed procedure, reverse shoulder replacement surgery.
During total shoulder replacement surgery, both the ball and the socket portions of the joint are replaced. This involves removing the top portion of the humerus and replacing the end of the bone with a stem insert and rounded edge. Next, the socket portion of the joint along the scapula is smoothed to remove damaged surfaces, and a small plastic or metal cap is used to create the new socket of the shoulder joint. Often, this new socket is held in place with a long-lasting surgical cement.
It’s important to remember that not all individuals will require total shoulder replacement. During partial shoulder replacement surgery — also known as shoulder hemiarthroplasty — only the ball of the joint is replaced.
Today, a new procedure known as reverse total shoulder replacement is used for individuals who are suffering from both arthritis of the shoulder and rotator cuff tears. A different approach is necessary in these cases because a standard shoulder replacement relies on the rotator cuff to provide support and stability to the joint. A reverse shoulder replacement instead depends on the deltoid muscles of the shoulder for this support. Reverse total shoulder replacement surgery was first widely utilized in Europe and was first approved for use in the U.S in 2003. At Sports Medicine Oregon, we specialize in the full suite of shoulder replacement surgeries, including reverse shoulder replacement surgery.
Following surgery, your doctor may prescribe pain medications to help with general pain. You will need to wear a sling to protect and support the joint for approximately two weeks, sometimes up to one month, following surgery. This immobilization will assist with the overall healing process and minimize the risk of injury. To the same end, it's important to limit activity involving the surgically repaired shoulder for the first few weeks following surgery. Your doctor or physical therapist will design a rehabilitation program for you to follow during recovery. Light exercises will begin a few days after the operation. These shoulder rehabilitation exercises will play an integral role in the overall shoulder replacement recovery process. To begin with, a physical therapist will demonstrate how to properly perform these shoulder surgery rehab exercises and guide you through safe, effective movements. Next, the therapist will create an individually tailored shoulder rehabilitation program you can follow at home, including detailed daily and weekly regimens with specific repetition goals.
Initially, shoulder rehabilitation exercises will focus on passive movements, but you can expect to begin more advanced shoulder replacement exercises approximately two to three months following the procedure. Strengthening the surrounding muscles will provide support and stability to the joint. Additionally, shoulder stretching exercises will help increase the range of motion and aid in the recovery process. It’s important to follow these exercises as recommended by your doctor. If any of these shoulder rehabilitation exercises lead to pain, be sure to discuss these symptoms with your healthcare provider before continuing the rehabilitation program.
As is the case with any surgery, patients should maintain realistic expectations about the recovery process to avoid setting themselves up for disappointment or pushing themselves too far. Each shoulder replacement surgery recovery will be unique, and it’s important not to rush the rehab process. It may take between nine months and a full year to make a full recovery.
Today, shoulder replacement surgery is a common, effective procedure. According to a recent report, 90 percent of shoulder replacements perform optimally 10 years after the procedure, and 80 percent of shoulder replacements last at least 20 years. Whether you are struggling with osteoarthritis shoulder pain, rotator cuff damage, or decreased range of motion, there are many treatment options that can restore strength and stability. At Sports Medicine Oregon, we offer a wide range of conservative care treatments, as well as surgical options when appropriate, to help athletes and active individuals achieve their activity and stability goals. Don’t let shoulder pain, discomfort, and decreased range of motion hold you back from your lifestyle ambitions. Take the next step to minimize your pain and maximize your activity today!
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