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Shoulder Replacement – Causes and When is it Necessary

Shoulder arthroplasty, more commonly known as shoulder replacement surgery, is a medical procedure aimed at reducing pain and restoring mobility of the shoulder joint in individuals suffering from severe joint damage. The surgical procedure involves replacing all or part of the shoulder joint with artificial components, or prosthetics. There are numerous conditions that can lead to having a shoulder replacement and the decision for surgery is typically taken when other treatment options fail to provide relief. This procedure can greatly improve the lives of patients by allowing them to regain their shoulder function and resume everyday activities with minimal discomfort.   

In the following sections, we will explore the common causes necessitating a shoulder replacement, the process of determining the need for the surgery, the rehabilitation and recovery process post-surgery, and insights into life after a shoulder replacement.

Common Causes and Symptoms Leading to a Shoulder Replacement

The most common causes leading to shoulder replacement surgery primarily involve severe, degenerative conditions of the shoulder joint. One of the primary reasons is osteoarthritis, a condition in which the cartilage of the joint breaks down over time leading to limited and painful shoulder movement. Another common cause is rheumatoid arthritis, an autoimmune disease causing chronic inflammation, pain, and deformation of the shoulder joint. Injury-induced arthritis, resulting from severe trauma or fractures, can also necessitate shoulder arthroplasty. A condition known as rotator cuff tear arthropathy, a condition that arises from a long-standing rotator cuff tear, is another cause. Avascular necrosis, a condition where the blood supply to the humeral head is disrupted leading to bone death, frequently necessitates shoulder replacement as well. 

When is Shoulder Replacement Necessary?

Individuals experiencing pain and loss of shoulder function typically start with more conservative treatments including physical therapy, medications, and injections. Shoulder replacement surgery is a viable option for those that do not respond to conservative treatments and typically have the presence of degenerative changes to the joint or pathology of surrounding tissues. Key indicators that surgery might be required include chronic pain that disrupts daily activities or sleep, significant loss of mobility, or failure to respond to other treatments. It is essential to consult with a medical professional who can assess your condition and guide you toward the most appropriate treatment option.

Types of Shoulder Arthroplasty

  1. Total Shoulder Arthroplasty: This involves replacing both the humeral head (ball) and glenoid surface (socket). The shoulder joint retains its normal shape. 
  2. Shoulder Hemiarthroplasty: Unlike the total shoulder arthroplasty, this involves replacing only the head of the humerus with a prosthetic. The glenoid is kept as a bony surface and is not replaced.
  3. Reverse Total Shoulder Arthroplasty: The head of the humerus and glenoid surfaces are replaced; however, the shape of the shoulder is reversed. This means that the glenoid surface will now become the ball and the humerus will be the socket. This surgery is typically performed when the rotator cuff musculature is severely damaged. 

Recovery Post Shoulder Surgery 

Recovery from shoulder replacement surgery is dependent on the type of replacement performed and the surgeon’s protocol. Typically, the shoulder will be immobilized in a sling for 4-6 weeks post-op. Physical therapy is crucial for restoring range of motion and strength in the shoulder in an appropriate manner to protect the surgery and restore proper function of the shoulder. Pain and discomfort typically subside over weeks to months for most shoulder replacement surgeries, with full recovery typically occurring within six months to a year. During this period, regular follow-ups with medical professionals and adherence to the rehabilitation program are key to ensuring a successful recovery.

Life After Shoulder Replacement

Life after shoulder surgery gradually returns to normal, with most patients experiencing significant improvement in pain and mobility. As the healing process progresses, patients can slowly reintroduce daily activities such as dressing, cooking, and light housework. The timeline for return to work varies depending on the nature of the profession; desk jobs can typically be resumed within a few weeks, while more physically demanding occupations may require a longer recovery period. Many patients report not only a return to normal activities but also an enhanced quality of life due to the reduction in pain and increased function. Nonetheless, it’s important to note that everyone’s recovery journey will be unique, and patience is key in this process. Regular follow-ups with your doctor and physical therapist ensure a safe and effective return to regular life after shoulder replacement surgery.


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