- Procedure Details
- Risks / Benefits
- Recovery & Outlook
An Introduction to Shoulder Problems and Treatments
Whether you’ve sustained an athletic shoulder injury or have developed shoulder arthritis as you’ve aged, the pain, limited motion, and general weakness can leave you feeling incapable and depressed. At the Banner CORE Center for Orthopedics in Phoenix, AZ, we offer treatments like physical therapy, medication management, stretching, and shoulder surgery to help patients eliminate pain and get back to living.
Shoulder Anatomy and Background
The Shoulder Joint
The shoulder is essentially a ball and socket joint with superior mobility and range of motion. This mobility is dependent upon an array of muscles, tendons, and ligaments, which makes the shoulder one of the most complex joints in the body.
The socket, or glenoid, is part of the scapula (shoulder blade), and the ball is on the top end of the arm bone (humerus). With the help of the deltoid and rotator cuff muscles, the humerus moves and rotates within the socket, raising and twisting your arm.
The most common source of shoulder pain is arthritis, of which there are four main types:
- Osteoarthritis occurs when the smooth cartilage on the joint surfaces break down, leaving the underlying bone to grind on bone.
- Rheumatoid arthritis is a systemic (whole body) disease in which the body’s immune system attacks and destroys the joint surfaces.
- Traumatic arthritis may occur when the joint surface is disrupted by a fracture, ligament tear, or dislocation, making it more susceptible to arthritis.
- Rotator cuff tear arthritis is a small but special category of arthritis where a massive, irreparable rotator cuff tear is present. Special considerations are required to best treat this form of shoulder arthritis.
Managing Shoulder Arthritis
Depending on its cause and severity, dealing with shoulder arthritis every day can be incredibly frustrating and physically exhausting. Fortunately, there are a variety of surgical and non-surgical treatment options that can help you get your pain under control and increase your physical ability.
Before suggesting a surgical solution, doctors will commonly recommend a combination of non-surgical first-line treatments like physical therapy, stretching, strengthening, and non-steroidal anti-inflammatory medications. In certain cases, these methods may be sufficient to manage symptoms. If they are not, surgical options are considered.
If the cause of your shoulder problems cannot be easily diagnosed, an orthopedic shoulder surgeon may order an exploratory procedure in which a tiny camera (or “arthroscope”) is inserted into the shoulder joint. If the camera shows small tears or other simple issues, your surgeon may be able to repair them right away using tiny instruments attached to the arthroscope.
Total Shoulder Replacement
If the entire joint shows significant damage, your orthopedic shoulder surgeon may recommend a total shoulder replacement. In this procedure, the entirety of the ball and socket mechanism is replaced with an artificial joint made from metal and plastic. This advanced solution is typically recommended in cases where the glenoid bone, glenoid cartilage, and rotator cuff tendons are severely damaged.
Reverse Total Shoulder Replacement
In a reverse total shoulder replacement, the placement of the plastic socket and the metal ball head are switched. This surgery is usually recommended for those with irreparable damage to their rotator cuff tendons, as the reversed socket design allows them to raise their arms with their deltoid muscle instead.
Evaluation: Is Surgery for You?
If surgery is recommended, you’ll want to undergo a full evaluation and have any necessary testing done to make sure you’re a good candidate for the procedure. Talk to your surgeon and your primary physician about your options, and weigh the pros and cons of surgery with loved ones you trust.
If your shoulder symptoms can be managed non-surgically to a sufficient degree, you may decide to forgo surgery. If the symptoms are still making it difficult to live your life despite physical therapy and medications, surgery may be the most effective choice.
Going Through with Surgery
Realistic Expectations About Shoulder Replacement Surgery
If you do choose to have shoulder surgery, keep a realistic mindset about the treatment. You will have to put in work and carefully follow your surgeon’s rehabilitation plan for up to a year to ensure the best results. Patients do commonly experience pain, weakness, and limited motion immediately following surgery, but these will improve over time with proper rehabilitation.
Complications from total shoulder replacement surgery are quite rare. Shoulder replacement problems may include stiffness, slippage of the ball from the socket, problems with glenoid tissue, post-operative infection, and/or nerve damage.
Your Shoulder Replacement Surgery
One to two weeks prior to surgery, the Banner CORE Center for Orthopedics may request a medical evaluation to ensure any medical conditions—such as a urinary tract infection, high blood pressure, or heart disease—are detected and treated appropriately prior to surgery.
In addition to completing this evaluation, remember to arrange for post-operative care with a trusted individual (e.g., a spouse or family member). For several weeks, you will likely need help with everyday tasks, including bathing yourself. If you don’t have someone to help you at home, you may want to make arrangements with a rehabilitation facility for recovery.
In a total shoulder replacement, surgeons remove the scapula and the ball of the humerus and replace them with a metal ball and plastic socket (held in place with surgical bone cement or grafted onto existing bone using advanced materials). Depending upon the intensity of your surgery and other factors, you will be placed under either general or regional anesthesia. The procedure usually takes around two hours to complete.
Shoulder Replacement Recovery
After your surgery, you will be given antibiotics, pain medications, and any other medications your surgeon orders. Sometime within the 24 hours after you’re moved from recovery into a standard hospital room, a member of our physical therapy team will arrive to discuss your shoulder replacement rehab plan and begin some gentle shoulder exercises.
The length of your hospital stay varies greatly, depending on the type of surgery you have. For the average shoulder procedure at our center, two to three days is common.
At the Banner CORE Center for Orthopedics in Phoenix, we provide best-in-class surgical and non-surgical treatment options for those suffering from chronic shoulder pain. To learn more or schedule an evaluation, call us today at 1-855-409-7520.