Though shoulder replacement surgery is not needed as frequently as hip or knee replacement, it can be just as effective in relieving chronic joint pain caused by arthritis. If nonsurgical treatments have not been effective in relieving symptoms, and shoulder pain interferes with the patient’s daily activities, shoulder replacement surgery may be an option.
Our shoulder replacement specialists at Orthopedic Specialty Clinic are Dr. Erik Krushinski and Dr. Eli Xhaferi. Dr. Krushinski completed a fellowship in sports medicine, with a particular focus on shoulder and knee surgery. Dr. Xhaferi is fellowship trained in joint replacement surgery. Each specialist has over 10 years of experience with shoulder replacement surgery.
Candidates for Shoulder Replacement Surgery
Our shoulder specialists only recommend surgery if they feel it is in the best interest for the patient. Unless the shoulder arthritis is very severe, or the patient has a fracture, they will typically recommend nonsurgical treatment as a first course of action. Nonsurgical treatments may involve anti-inflammatory medications, cortisone injections, and physical therapy.
If nonsurgical treatments are not effective in relieving shoulder pain and improving function, surgery may be considered. Candidates for shoulder replacement surgery typically have the following:
- Shoulder pain that is severe enough to interfere with daily activities, such as reaching overhead, getting dressed, or washing
- Pain that persists while at rest, which may interfere with getting a good night’s sleep
- Weakness or reduced range of motion in the shoulder
- Failed nonsurgical treatment
Shoulder replacement surgery may also be recommended for patients with severe shoulder fractures or large rotator cuff injuries.
Shoulder Replacement Options
There are different shoulder replacement options available to help relieve pain and improve shoulder function. Dr. Krushinski and Dr. Xhaferi will recommend the procedure that best fits the patient’s needs and symptoms.
Total Shoulder Replacement
Total shoulder replacement is the traditional joint replacement procedure for patients with shoulder arthritis. During this procedure, our shoulder surgeons remove the ball-shaped portion of the upper arm (called the humeral head) and replace it with a stemmed metal implant with a metal ball on the end. The shoulder socket is then lined with a plastic component, and the metal ball fits into it.
Total shoulder replacement is typically recommended for patients who have bone-on-bone arthritis in the shoulder and an intact rotator cuff.
Reverse Total Shoulder Replacement
With a reverse total shoulder replacement, the positioning of the ball and socket components are swapped. The ball-shaped end of the upper arm bone is removed and replaced with a stemmed socket component, and a metal ball is attached to the natural shoulder socket.
Reverse total shoulder replacement is recommended for patients with severe rotator cuff tears, or those who have developed arthritis as the result of a previous rotator cuff tear. These patients may still have shoulder pain and weakness with a traditional total shoulder replacement, because the rotator cuff is weakened. By reversing the positioning of the ball and socket components of the joint, the shoulder can rely on the deltoid muscle to lift the arm instead of the rotator cuff.
During a hemiarthroplasty, only the ball portion of the shoulder joint is replaced or resurfaced. If a patient has a fracture involving the humeral head, but the shoulder socket is intact, replacing only the humeral head may be recommended.
If the humeral head is not fractured but has significant cartilage damage, and the socket is intact, a resurfacing the humeral head with a smaller, cap-like prosthesis may be recommended. This allows preservation of more of the healthy bone, and may be a great option for younger, more active patients.
Recovering from Shoulder Replacement Surgery
After shoulder replacement surgery, most patients will stay in the hospital overnight and return home the following day. Prior to the procedure, patients receive general anesthesia with an indwelling pain catheter, which helps relieve pain for up to the first 72 hours after surgery.
On average, the incision is 4-5 inches long, but this may vary from patient to patient. Patients are instructed on how to care for the incision site before returning home. The arm will be in a sling for about 4 weeks after surgery. Patients start with at-home exercises for the first 2 weeks, then begin working with physical therapists on an outpatient basis.
Patients gradually return to activity as they progress in their recovery. Most patients are able to resume driving after 4 weeks.
The goal of shoulder replacement surgery is to alleviate shoulder pain and improve range of motion, though return of full range of motion may not be possible for all patients.
Shoulder Replacement in Fredericksburg, VA
Dr. Erik Krushinski and Dr. Eli Xhaferi, our shoulder replacement specialists, each have over 10 years of experience with shoulder replacements. Our specialists offer traditional total shoulder replacement, reverse total shoulder replacement, and hemiarthroplasty to help reduce pain and improve shoulder function for patients with solutions tailored to their needs. If you would like to schedule an appointment with Dr. Krushinski or Dr. Xhaferi, please call our office at (540) 361-1830 or request an appointment via our convenient online form.