An important part of maintaining an active, healthy lifestyle is having flexibility and mobility in the shoulder. Nagging symptoms such as chronic pain and arthritis that limit mobility can limit a person’s ability to participate fully in life. For these patients, shoulder replacement can make a huge difference in the level of enjoyment they can get out of life.

When Shoulder Pain Becomes Chronic

On-going or chronic shoulder pain can be the result of osteoarthritis, rheumatoid arthritis, or it can stem from an injury resulting from an accident or fall. Persistent severe shoulder injuries that do not respond to non-surgical treatments and physical therapy may benefit from shoulder replacement surgery. There are several reasons why shoulder replacement surgery may be a good option. When patient suffer from

  • severe shoulder pain that interferes with normal routines and activities
  • moderate to severe pain while resting that interferes with a normal sleep patterns
  • loss of motion and weakness in the shoulder
  • lack of improvement after trying anti-inflammatory medications, cortisone injections, or physical therapy

There are different types of shoulder replacements.

Stemmed Hemiarthroplasty

When indicated, the surgeon may replace just the ball part of the joint in a procedure called a hemiarthroplasty. In a traditional hemiarthroplasty, the head of the humerus is replaced with a metal ball and stem, similar to the component used in a total shoulder replacement. This is called a stemmed hemiarthroplasty. Some surgeons recommend hemiarthroplasty when the humeral head is severely fractured but the socket is normal.

Resurfacing Hemiarthroplasty

Resurfacing hemiarthroplasty involves replacing just the joint surface of the humeral head with a cap-like prosthesis without a stem. With its bone preserving advantage, it offers those with arthritis of the shoulder an alternative to the standard stemmed shoulder replacement. For patients who are young or very active, resurfacing hemiarthroplasty avoids the risks of component wear and loosening that may occur with conventional total shoulder replacements in this patient population. Due to its more conservative nature, resurfacing hemiarthroplasty may be easier to convert to total shoulder replacement, if necessary at a later time.

Two types of  Total Shoulder Replacement Surgery

There are two major types of shoulder replacement available to patients suffering from chronic shoulder pain: standard and reverse. The major difference between a standard shoulder replacement and a reverse procedure is that in a reverse shoulder replacement (RTSR) the ball and socket parts of the shoulder joint switch locations. With reverse total shoulder replacement, the surgeon changes the structure of the joint and the socket and metal ball are switched. With traditional total shoulder replacement, the ball and socket of the joint are simply replaced. The reverse total shoulder replacement procedure swaps the position of the ball and socket because of irreparable rotator cuff damage. By reversing the ball and socket, the surgeon can mechanically repair the shoulder allowing for improved function and pain control.

More than 53,000 people in the U.S. have shoulder replacement surgery each year, according to the Agency for Healthcare Research and Quality. In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis. With a standard total shoulder replacement procedure muscles and tendons around the shoulder joint are still healthy and can support a new joint. In this situation, muscles attach to the shoulder blade as they should, and are supported by tendons which connect to the shoulder. This configuration of muscles and tendons makes it possible to move the shoulder normally.

In some patients, these tendons can sustain damage and become torn to the point that they no longer support the bone structure of the shoulder, causing pain and significant loss of motion. Where a standard total shoulder replacement procedure works great for patients where the supporting muscles and tendons of the rotator cuff are functional, a reverse total joint procedure is the better choice where it is torn or damaged.

SRO Shoulder Specialists

SRO’s team of board-certified and fellowship trained elbow and shoulder subspecialists combine extensive knowledge and experience with state-of-the-art surgical techniques. The expanded team of SRO professionals includes; medical assistants, physical and occupational therapists and staff who all work together to ensure that each patient benefits from an extraordinary continuum of care that only SRO can provide. Learn more …


*Information for this article provided by AAOS OrthoInfo