Shoulder arthritis can be a disabling condition that causes stiffness, pain, and loss of function of the shoulder joint. As shoulder motion is such an integral part of our daily activities, shoulder arthritis can cause significant disability. Although there are many conservative treatments for arthritis including anti-inflammatory medication, injections and physical therapy, shoulder replacement may be performed in order to provide pain relief and potentially improve function.
There are two main types of replacements used. There is traditional total shoulder replacement that is used for osteoarthritis of the shoulder. There is also reverse total shoulder replacement that is used for arthritis of the shoulder secondary to loss of the rotator cuff. Both technologies have demonstrated predictable relief of pain with high rates of success and improved longevity compared to earlier generation implants.
The surgery is performed through an incision in front of the shoulder. This allows for the best visualization to appropriately position components while minimizing the risks to nerves and vessels. Both the ball and socket of the shoulder are replaced with components specially sized to the individual.
All shoulder replacement surgeries require careful planning. This begins from the moment a patient is seen in consultation. There are many health factors that are taken into consideration before surgery in order to minimize the chance of complications and improve outcomes. There are often medical conditions that require further treatment by an internist or specialist prior to surgery. We believe that a comprehensive approach to patient care is the best way to achieve a healthy and functional recovery.
The surgeons at Florida Joint Care Institute use cutting edge digital X-rays calibrated to each patient as well as specialized computer software to plan the surgery. This ensures appropriate component selection to match each patient’s anatomy. During the surgery there is additional instrumentation that measures anatomy directly to ensure sizing is exact. There is no more precise way to measure size and restore anatomy than planning the surgery appropriately and verifying using this direct technology during the operation.
Rehabilitation after surgery reflects the extensive planning given to each patient’s surgery. The majority of patients will start physical therapy to walk the same day of surgery with the use of a sling. This improves early functional recover and lowers the risks of blood clots from forming. All patients recover in a private room and work with the orthopaedic and nursing teams within the joint care program. Most patients are confident with their mobility and by the second or third day are discharged home with a home visiting nurse and therapist. If additional needs are required, a patient may elect to go to a rehabilitation facility to work aggressively with physical therapy until enough independence is reached to be discharged home.
Recovery occurs as a stepwise process. There may be specific limitations in mobility prescribed by your surgeon for the first six weeks. At this point in time, a patient no longer requires a sling for support and can progress active mobility with physical therapy. The majority of mobility and function is restored within the first three to four months after surgery and endurance continues to improve as activities are resumed.
Although shoulder replacement technology has been refined over several decades, and outcomes are better than ever, there are unique risks inherent to the operation. With careful planning these risks are minimized but it is important to have this discussion with your surgeon prior to the operation to be appropriately informed. By understanding these risks and expectations of benefits, our patients are able to achieve the best outcomes possible.