Shoulder Replacement

As the body’s most flexible joint, the shoulder gives strength and range of motion to the arm. It is more susceptible to injury and overuse than some of the other joints. Though less common than hip or knee replacement, shoulder replacement is an effective treatment for the pain associated with osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, rotator cuff damage, severe fractures and/or avascular necrosis (death of bone tissue that occurs when blood supply is disrupted).

Baptist Health is nationally recognized for excellence in shoulder replacement surgery. We offer a full spectrum of orthopedic care and surgical approaches to shoulder replacement surgery, including shoulder replacement specialists. Best of all, you will appreciate convenient appointment times, locations near you and a personalized focus to meet your needs before, during and after your procedure.

What is Shoulder Replacement Surgery & How Is It Done?

During shoulder replacement surgery, an orthopedic surgeon removes damaged parts of the shoulder joint and replaces them with artificial materials known as a prosthesis. Shoulder replacement surgery usually takes a few hours and may require anesthesia depending on the surgery type performed. After the shoulder replacement procedure, patients are moved to a recovery room and later to a hospital room. 

Types of Shoulder Replacement Surgery

Shoulder replacement surgery can be performed in multiple ways depending on the injury type. Shoulder replacement may include replacement of only the head or “ball” of the upper arm bone (humerus) or replacement of both the ball and the “socket” (glenoid cavity), better known as total shoulder replacement surgery. There are a few types of shoulder replacement surgery:

Total Shoulder Replacement Surgery

Total shoulder replacement surgery involves replacing the damaged humeral head with a metal ball attached to a stem that fits into the humerus, and putting a new smooth plastic surface on the glenoid (called the “socket”). Metal on plastic surfaces (rather than metal on metal) are the hallmark of virtually all shoulder replacement implant systems. If the patient’s arm bone is in good condition, the surgeon can use a press-fit component that fits snuggly within the bone and as healing takes place the prosthetic is made to allow for the bone to grow within the prosthetic for greater stability. If a patient has osteoporosis or another condition weakening the bone, the surgeon will implant the component using bone cement. Patients with osteoarthritis and intact rotator cuff tendons are good candidates for conventional total shoulder replacement.

Hemiarthroplasty (Ball-Only Replacement Surgery)

Partial shoulder replacement (or hemiarthroplasty) requires the replacement of the ball component only similar to the component used in a total shoulder replacement. This may be recommended when the humeral head is severely fractured but the socket is normal or if:

• Arthritis involves only the humeral head with a healthy socket (glenoid) that has intact cartilage. 
• A shoulder with severely weakened bone in the glenoid.
• A shoulder with a severely torn rotator cuff tendon and arthritis.

During a resurfacing hemiarthroplasty, the surgeon replaces just the joint surface of the humeral head with a cap-like prosthesis (no stem). If a patient has a glenoid with an intact cartilage surface, no fresh fracture of the humeral neck or head, and – especially – if he or she is young or very active and wants to avoid component wear and loosening, resurfacing hemiarthroplasty may be an option.

Reverse Total Shoulder Replacement Surgery

The rotator cuff muscles are important in shoulder movements and in maintaining shoulder joint stability. These muscles arise from the shoulder blade (scapula) and connect to the head of the humerus, forming a cuff at the shoulder joint. For people who have completely torn rotator cuffs with severe arm weakness, severe arthritis or a previous shoulder replacement that failed, the surgeon can attach the metal ball to the shoulder bone and the plastic socket to the humerus which allows the patient to use the deltoid muscle, instead of the torn rotator cuff, to lift his or her arm.

What Can Shoulder Replacement Surgery Accomplish?

Shoulder replacement surgery is recommended to treat severe pain of arthritis or a fractured or broken shoulder. The procedure can restore comfort and function by:

• Relieving shoulder pain
• Improving the function of the shoulder joint
• Increasing comfort in doing daily activities

How to Prepare for Shoulder Replacement Surgery

Before shoulder replacement surgery you should make sure your physician knows all the medications you are currently taking, as some may need to be stopped shortly before surgery. The evening before surgery you will be instructed not to eat or drink anything after midnight and leading up to your surgery the next day.

You may want to contact your physical therapist before the surgery, so you can discuss the recovery process and therapy treatments, so you know what to expect during recovery.

Making preparations ahead of time for a helper around the house after surgery is also suggested. You will not have use of the shoulder that was operated on for a few days and if this is your dominant hand, it may be challenging to do some normal daily functions by yourself, such as bathing or grabbing a dish from a high cupboard.

What to Expect During Shoulder Replacement Surgery Recovery

After shoulder replacement surgery you will have some pain, especially the first couple days of recovery. You may be in the hospital overnight and will be asked to get up and get moving around in the day following surgery so that rehabilitation can begin. Pain will be managed with oral medications and you will be sent home with a prescription to manage pain for the first week of shoulder replacement surgery recovery.

Your arm will be in a sling for a week or two to minimize excessive movement of the shoulder before therapy has allowed the shoulder to recover from the surgery. You will work with a physical therapist after the surgery for the months following shoulder surgery to regain range of motion and strength. Most daily activities can be resumed normally within 2-4 weeks but could be up to 6 months before resuming activities like golf or swimming.

Types of Shoulder Replacement Surgery

Shoulder replacement surgery can be performed in multiple ways depending on the injury type. Shoulder replacement may include replacement of only the head or “ball” of the upper arm bone (humerus) or replacement of both the ball and the “socket” (glenoid cavity), better known as total shoulder replacement surgery. There are a few types of shoulder replacement surgery:

Total Shoulder Replacement Surgery

Total shoulder replacement surgery involves replacing the damaged humeral head with a metal ball attached to a stem that fits into the humerus, and putting a new smooth plastic surface on the glenoid (called the “socket”). Metal on plastic surfaces (rather than metal on metal) are the hallmark of virtually all shoulder replacement implant systems. If the patient’s arm bone is in good condition, the surgeon can use a press-fit component that fits snuggly within the bone and as healing takes place the prosthetic is made to allow for the bone to grow within the prosthetic for greater stability. If a patient has osteoporosis or another condition weakening the bone, the surgeon will implant the component using bone cement. Patients with osteoarthritis and intact rotator cuff tendons are good candidates for conventional total shoulder replacement.

Hemiarthroplasty (Ball-Only Replacement Surgery)

Partial shoulder replacement (or hemiarthroplasty) requires the replacement of the ball component only similar to the component used in a total shoulder replacement. This may be recommended when the humeral head is severely fractured but the socket is normal or if:

• Arthritis involves only the humeral head with a healthy socket (glenoid) that has intact cartilage. 
• A shoulder with severely weakened bone in the glenoid.
• A shoulder with a severely torn rotator cuff tendon and arthritis.

During a resurfacing hemiarthroplasty, the surgeon replaces just the joint surface of the humeral head with a cap-like prosthesis (no stem). If a patient has a glenoid with an intact cartilage surface, no fresh fracture of the humeral neck or head, and – especially – if he or she is young or very active and wants to avoid component wear and loosening, resurfacing hemiarthroplasty may be an option.

Reverse Total Shoulder Replacement Surgery

The rotator cuff muscles are important in shoulder movements and in maintaining shoulder joint stability. These muscles arise from the shoulder blade (scapula) and connect to the head of the humerus, forming a cuff at the shoulder joint. For people who have completely torn rotator cuffs with severe arm weakness, severe arthritis or a previous shoulder replacement that failed, the surgeon can attach the metal ball to the shoulder bone and the plastic socket to the humerus which allows the patient to use the deltoid muscle, instead of the torn rotator cuff, to lift his or her arm.

What Can Shoulder Replacement Surgery Accomplish?

Shoulder replacement surgery is recommended to treat severe pain of arthritis or a fractured or broken shoulder. The procedure can restore comfort and function by:

• Relieving shoulder pain
• Improving the function of the shoulder joint
• Increasing comfort in doing daily activities

How to Prepare for Shoulder Replacement Surgery

Before shoulder replacement surgery you should make sure your physician knows all the medications you are currently taking, as some may need to be stopped shortly before surgery. The evening before surgery you will be instructed not to eat or drink anything after midnight and leading up to your surgery the next day.

You may want to contact your physical therapist before the surgery, so you can discuss the recovery process and therapy treatments, so you know what to expect during recovery.

Making preparations ahead of time for a helper around the house after surgery is also suggested. You will not have use of the shoulder that was operated on for a few days and if this is your dominant hand, it may be challenging to do some normal daily functions by yourself, such as bathing or grabbing a dish from a high cupboard.

What to Expect During Shoulder Replacement Surgery Recovery

After shoulder replacement surgery you will have some pain, especially the first couple days of recovery. You may be in the hospital overnight and will be asked to get up and get moving around in the day following surgery so that rehabilitation can begin. Pain will be managed with oral medications and you will be sent home with a prescription to manage pain for the first week of shoulder replacement surgery recovery.

Your arm will be in a sling for a week or two to minimize excessive movement of the shoulder before therapy has allowed the shoulder to recover from the surgery. You will work with a physical therapist after the surgery for the months following shoulder surgery to regain range of motion and strength. Most daily activities can be resumed normally within 2-4 weeks but could be up to 6 months before resuming activities like golf or swimming.