A shoulder replacement is a procedure that involves replacing the shoulder joint with artificial components to reduce or eliminate pain and restore function.

Shoulder replacement surgeries can be complex, and you’ll want an experienced and innovative surgeon to perform this procedure. At The Ohio State University Wexner Medical Center in Columbus, Ohio, our highly skilled orthopedic surgeons specialize in joint replacement surgeries and utilize different surgical approaches, including patient-specific custom implants, not always available elsewhere. The approach is specifically selected for your unique situation, considering your anatomy, activity level and condition.

As part of a large academic medical center, our joint replacement experts work collaboratively alongside other orthopedic specialists and sports medicine doctors to determine if, and when, a shoulder replacement might be the best option for treating your condition. Whether you’re an injured athlete looking to stay active or a senior with mobility issues wanting to stay independent, we’ll spend time getting to know you and get you back to enjoying life quickly.

What is a shoulder replacement?

A shoulder replacement, also known as shoulder arthroplasty, is a surgical procedure that removes damaged bone to relieve pain, stiffness or weakness in the shoulder. The procedure can often restore lost function, too. During the surgery, we replace parts of the shoulder (ball, socket) with artificial components, typically made of metal or plastic, called prostheses.

There are various types of shoulder replacements done at the Ohio State Wexner Medical Center, depending on your condition. You might need a shoulder replacement if you have arthritis in your shoulder, a rotator cuff tear or other shoulder injury from overuse or trauma.

Roughly 100,000 people in the United States receive a shoulder replacement each year. Many of them travel from out of state to have their shoulder surgery done at the Ohio State Wexner Medical Center because of our expertise in orthopedic reconstruction and our approach to joint replacement care.

Shoulder replacement is not the first line of treatment for most shoulder injuries. At the Ohio State Wexner Medical Center, we make sure you’ve tried many nonsurgical treatments, such as physical therapy and injections, before we recommend a shoulder replacement.

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Types of shoulder replacement surgery

Choosing the type of joint replacement that will be most beneficial to you can give you a better chance of recovering quickly and with significant symptom reductions. Types of shoulder replacements include:

  • Partial shoulder replacement – Also called hemiarthroplasty, this procedure involves replacing only the head (ball) of the joint. This works best when only the ball side of the joint is damaged.
  • Anatomic total shoulder replacement – Both the ball and socket are replaced. The prosthetic parts are made of metal or plastic and closely resemble the shape of natural bones.
  • Reverse shoulder replacement – For this type of replacement, the prosthetic ball and socket are placed in the reverse position, meaning the implant ball is placed where the natural socket was, and the cupped socket attaches to the stem and the upper arm (humerus). This method is often preferred when the rotator cuff is badly damaged.

While there are three main types of shoulder replacement, there are other variations we consider when planning your shoulder surgery. These procedures can be done on an outpatient basis, meaning you go home the same day as your surgery. For people who require more time to recover, we offer inpatient surgeries allowing you to stay overnight and be taken care of at the medical center.

What is the difference between anatomic shoulder replacement and reverse shoulder replacement?

In traditional total shoulder replacement surgery, the artificial ball and socket are attached where the natural ball and socket were. In a reverse shoulder replacement, the artificial parts are reversed. The ball attaches to the socket, and the artificial socket or cup, attaches to the upper arm to allow better function when the rotator cuff is damaged.

When to consider shoulder arthroplasty

Shoulder replacement surgery can be used to treat a variety of conditions. Common conditions that might require a shoulder replacement include:

While these conditions can sometimes lead to activity-limiting pain and loss of function requiring a shoulder replacement, remember that a shoulder replacement is rarely the first treatment we’ll offer. At times, a shoulder replacement is the best treatment based on a variety of factors. But, typically, before recommending surgery, our expert orthopedic and sports medicine specialists will try a variety of nonsurgical methods to preserve the joint, including:

If these treatments don’t work as well as we’d like, you might be a candidate for a shoulder replacement.

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Preparing for a shoulder replacement

Trying other therapies for pain relief is essential prior to a recommendation for surgery. When you meet with your orthopedic reconstruction surgeon, the doctor will make sure you’ve had access to these various treatment methods and give you a physical examination, paying close attention to the injured area.

We might also perform imaging, such as X-rays, computed tomography (CT) scans or magnetic resonance imaging (MRI), and talk to you about your pain level and day-to-day quality of life. In preparation for surgery, pre-operative testing, such as blood tests and an electrocardiogram (EKG), may be indicated.

Prior to surgery, have a caregiver available to take you to and from the medical center and help you in the days following surgery. The night before surgery, refrain from eating or drinking, since you’ll be under general anesthesia during the procedure, and follow any other orders from your care team.

How is a shoulder replacement surgery performed?

How a shoulder replacement is performed will depend on the type of surgery, but it will follow these steps:

  • An IV is inserted through which we administer general anesthetics, so you’ll be asleep during the procedure and won’t feel any pain.
  • Typically, a nerve block is performed, which will numb the affected arm prior to surgery.
  • During the procedure, which lasts roughly two hours, the surgeon makes an incision on your shoulder, removes damaged areas and replaces those areas with artificial joints.
  • Then, the surgeon closes the incision using stitches or another method.
  • Finally, you’re taken to a recovery room where you wake up and remain for observation until it’s safe to go to your inpatient room or return home (if your procedure is outpatient).

Recovery after a shoulder replacement

How long recovery will take and what it looks like are frequent questions for those contemplating shoulder replacement surgery. While recovery will vary for people depending on the condition they have, type of replacement and their overall health, you typically begin physical rehabilitation several weeks after surgery, following the initial healing.

You’ll be able to do some simple movements only a few days after surgery, but there will be restrictions on your activity level for at least a few weeks, including not lifting anything more than five pounds or not driving.

Several weeks post-surgery, you’ll begin rehabilitation with our physical medicine and rehabilitation specialists. Working with them and doing exercises at home will be key to a successful recovery.

Other tips for the best results after shoulder replacement surgery include:

  • Take acetaminophen (Tylenol) on a schedule for pain management (narcotic pain medications will be prescribed to take as needed)
  • Apply ice after surgery
  • Rest, and designate a caregiver to help with tasks around the house so you can get adequate sleep
  • Don’t overexert yourself, especially in the early days after replacement
  • Follow restrictions for driving, lifting objects and other activities to prevent damage
  • Attend physical therapy appointments and complete exercises at home

People may begin to return to normal activities three to six months after surgery, but remember that recovery takes time and is a process. Recovery from shoulder replacement does take longer than with other joint replacement surgeries.

Shoulder replacement benefits

Though full recovery from a shoulder replacement takes time and effort with rehabilitation, there are advantages to having such a procedure. Most people who have a shoulder replacement have their pain significantly decreased or eliminated altogether. They also experience improved range of motion and strength.

Risks of a shoulder replacement

We take every precaution to minimize risks, but complications of shoulder arthroscopy can include:

  • Dislocation of the new ball and socket
  • Fracture of the humerus, shoulder blade or glenoid bone during or after surgery
  • Implant loosening over time
  • Nerve damage
  • Infections
  • Blood clots

Though rare, it’s also possible that the surgery fails to fix the shoulder issue, and sometimes another surgery is needed.

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