SHOULDER ARTHROPLASTY

The shoulder is a ball and socket joint that enables you to raise, twist, bend and move your arms forward, to the sides and behind you. The head of the upper arm bone (humerus) is the ball and a circular depression (glenoid) in the shoulder bone (scapula) is the socket. A soft tissue rim (labrum) surrounds and deepens the socket. The head of the upper arm bone is coated with a smooth, durable, covering (articular cartilage) and the joint has a thin, inner lining (synovium) for smooth movement. The surrounding muscles and tendons provide stability and support.

Many people know someone with an artificial knee or hip joint. Less common, but just as successful in relieving joint pain is a shoulder replacement (arthroplasty). This procedure may be recommended if arthritis or degenerative joint disease makes your shoulder stiff and painful, or if the upper arm bone is fractured so badly that tissue death may result.

Shoulder replacement surgery replaces damaged joint surfaces with artificial parts (prostheses). Usually there are two components: The humeral component replaces the head of the upper arm bone. It is made of metal (usually cobalt/ chromium-based alloys) and has a rounded ball attached to a stem that fits into the bone. This component comes in various sizes and is a modular unit.

The glenoid component replaces the socket (the glenoid depression). It is made of an ultra - high density polyethylene (plastic). Depending on the damage to your shoulder, you may have just the humeral head replaced (hemiarthroplasty) or both the humeral head and the glenoid replaced (total shoulder replacement). The components are held in place with either acrylic bone cement (cemented) or rely on bone ingrowth (press fit, or cementless). As in the native joint, the surrounding muscles and tendons provide stability for the prosthesis.

The risks of the surgery include but are not limited to:

Postoperative Instructions

You will wake up in the operating room with a sling in place. You will go to the recovery room and then be transferred to your hospital room after a few hours. You can get out of bed when you wish. You should continue to apply ice to your shoulder to reduce pain and swelling. (An ice machine that circulates cold water to the shoulder may be applied in the operating room).

Pain is usually controlled for the first 18-36 hours via a regional anesthetic “nerve block” with catheter and pump that will slowly trickle in medication. While the block is in effect, the operative hand and arm will usually be completely numb. Afterwards you will be transitioned to oral pain medications such as hydrocodone. While a blood transfusion is rare, it is occasionally necessary.

You may be discharged home on either the first or second postoperative day. You will need someone to assist you at home, so family should be aware that you will need help with simple daily living chores such as dressing, cooking, and feeding your self. Upon discharge from the hospital you will visit a TMI Physical Therapist in Dr. Robertson’s office, where they will begin the post-operative therapy program, show you some exercises for home, and change your bandage if necessary.