“Shoulder replacement, also known as shoulder arthroplasty, is the removal of portions of the shoulder joint, which are replaced with artificial implants to reduce pain and restore range of rotation and mobility. It is very successful for treating the severe pain and stiffness caused by end-stage arthritis or due to injury.”

Shoulder replacement surgery is less common than knee or hip replacements. But more than 3000 shoulder replacements are done in India every year.

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The Shoulder Joint 

It is ball-and-socket joint type joint. The bone in your upper arm (humerus) has a round end that acts as a ball and  fits into the curved structure (socket) on the outside of your shoulder blade.

Ligaments, tendons and muscles hold it together. A layer of tissue, cartilage keeps the bones apart, so they don’t rub against each other.

The ball and socket type joint lets you move your arm up and down, back and forward, or in a circle.

Shoulder Replacement – Why you need it !

In conditions where you have severe pain and not able to move and use shoulder joint 

• Shoulder Injury – Shattered bone around shoulder 
• Severe osteoarthritis 
• Torn rotator cuff with arthropathy 

If you have not got relief from physical therapy and pain medicine, doctor may advise you surgery.

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What is done in surgery 

Shoulder surgeon will replace the bone in the ball and socket of your shoulder joint with a material that could be metal and plastic. You will need physical therapy the surgery.

There are three types of shoulder replacement surgeries:

Total shoulder replacement: This is the most common type shoulder replacement. Here the surgeon replaces the ball at the top of your humerus with a metal ball, which gets attached to the remaining bone. The socket of the joint gets covered with a new plastic surface.

Hemi shoulder replacement: Only the ball gets replaced at the top of your humerus with a metal ball.

Reverse shoulder replacement:

This is done mostly if they have a torn rotator cuff with arthropathy.

Nowadays due to better results also done in case of fracture around shoulder with shattered bone.  

It’s also done when another shoulder replacement surgery didn’t work.

This is called reverse because here ball get replaced with socket and socket with a ball. Here functions of the shoulder are better despite poor rotator cuff tissue. The metal ball gets attached to your shoulder bones, and a socket is implanted at the top of your arm.

Preparing for Your Surgery

Your Shoulder surgeon will do a full examination of your shoulder. X-rays, CT scan MRI or other imaging tests will be required.

Talk to your doctor about any other  medical conditions you have and any medications you take. You will have to stop taking certain drugs, especially painkillers, several weeks before surgery

The procedure takes about 2 hours.

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Recovery

You can expect to spend 2 to 4 days in the hospital after your operation.  You will be given pain medicine to reduce pain. Cold compression can help control the swelling.

At first, your arm will be kept in a brace to give rest. Within a few days your doctor will  start physical therapy to get your arm and your new shoulder started working.

You will do exercises that will gradually improve how your new joint works.

Don’t rush things:

It may take 4 to 6 weeks before you can pick up anything heavier than a glass of water .

Your arm will be in an arm sling for most of your recovery. It may be 8 to 10 weeks or more before you can drive again.

You will go for several follow-up visits with your doctor so they can see how your recovery is going.

Complications

Most people have full motion in their shoulder and return to their daily routine after shoulder replacement surgery. But as with any operation, there is a chance of complications.

Infection or bleeding: You will be given antibiotics after your surgery to lower your chances of infection.

Dislocation: This happens when the ball slips out of the socket.

Nerves around your shoulder may get damaged: They usually recover with time.

After years of use, the replacement joint may become loose or separate from the bone: You may need surgery to fix it.

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Author is senior Shoulder and knee orthopaedic surgeon in Jaipur, India