Dr Nikunj Agrawal and team at Advance+ Orthopaedics is a centre for excellence for shoulder and sports related injuries. Common procedures performed are arthroscopic bankart repair for recurrent disclocation shoulder, arthroscopic Rotator cuff repair , subacromial decompression , SLAP repairs, and many other shoulder surgeries.

Shoulder replacement surgery, also known as shoulder arthroplasty, is a surgical procedure performed to relieve pain and restore function in patients suffering from severe shoulder joint damage or conditions such as osteoarthritis, rheumatoid arthritis, rotator cuff tear arthropathy, or avascular necrosis. It involves replacing the damaged or diseased parts of the shoulder joint with artificial components made of metal, plastic, or ceramic. The procedure aims to reduce pain, improve range of motion, and enhance overall shoulder function.

Shoulder Replacement

Types of Shoulder Replacement Surgery:

  1. Total Shoulder Replacement: In this procedure, the damaged humeral head (upper arm bone) & the glenoid (socket) are both replaced with artificial components. It is commonly recommended for patients with intact rotator cuff tendons and a well-functioning deltoid muscle.
  2. Reverse Shoulder Replacement: Reverse shoulder replacement involves reversing the ball and socket components of the shoulder joint. The artificial socket is attached to the humerus, and the artificial ball is placed on the glenoid. This type of surgery is typically recommended for patients with irreparable rotator cuff tears or certain types of fractures.
Need for Total Elbow Replacement:

Total elbow replacement is occasionally necessary when the elbow joint is severely damaged due to conditions like rheumatoid arthritis, osteoarthritis, or fractures. It is performed to relieve pain, restore joint function, and enhance the quality of life. The decision to perform total elbow replacement is based on the extent of joint damage, patient symptoms, and the failure of conservative treatments.

Benefits of Shoulder Replacement Surgery:
  1. Pain relief: Shoulder replacement surgery can significantly alleviate chronic shoulder pain, allowing patients to engage in daily activities with reduced discomfort.
  2. Improved range of motion: The surgery can restore shoulder joint mobility and increase the range of motion, enabling patients to perform various tasks and activities.
  3. Enhanced shoulder function: Shoulder replacement surgery aims to restore strength and function in the shoulder, enabling individuals to regain the ability to perform daily activities and enjoy an active lifestyle.
Candidates for Shoulder Replacement Surgery:

Ideal candidates for shoulder replacement surgery may have:

  • Chronic shoulder pain that interferes with daily activities
  • Severe shoulder joint damage caused by arthritis or other conditions
  • Failed non-surgical treatments such as physical therapy or medication
  • Good overall health with no medical conditions that may hinder the surgery or recovery process
Preparation for Shoulder Replacement Surgery:

To prepare for shoulder replacement surgery, patients may be advised to:

  • Undergo a thorough medical evaluation, including physical examination, imaging tests & blood work.
  • Discuss current medications with the healthcare provider, who may recommend temporary discontinuation or adjustments.
  • Stop smoking, if applicable, as it can impede the healing process.
  • Arrange for assistance with daily activities during the recovery period.
  • Follow any specific instructions provided by the surgeon, such as fasting before the procedure.
Procedure and What to Expect:

The shoulder replacement surgery typically involves the following steps:

  1. Anaesthesia: The patient is given either general anaesthesia or regional anaesthesia (numbing the arm and shoulder area).
  2. Incision: An incision is made to access the shoulder joint.
  3. Joint Preparation: The damaged parts of the joint are removed, including the humeral head & the damaged cartilage on the glenoid.
  4. Component Placement: The artificial components, including the humeral head, the glenoid socket, and any additional components required, are securely implanted.
  5. Closure: The incision is closed using stitches or staples, and a sterile dressing is applied.

After the surgery, patients can expect to stay in the hospital for a few days for monitoring. Physical therapy may be recommended to aid in the recovery process and regain strength and mobility.

Risks and Complications:

While shoulder replacement surgery is generally safe, some risks and complications may include:

  • Infection
  • Blood clots
  • Nerve or blood vessel injury
  • Dislocation of the artificial joint
  • Fracture during or after surgery
  • Loosening or wear of the artificial components over time
Recovery and Precautions:

Recovery from shoulder replacement surgery is a gradual process that requires patience and adherence to post-operative instructions. Some general guidelines for recovery and precautions include:

  • Regular physical therapy exercises to regain strength and range of motion.
  • Avoiding heavy lifting or strenuous activities as recommended by the surgeon.
  • Wearing a sling or immobiliser as instructed.
  • Practising good wound care and hygiene to prevent infection.
  • Following a healthy diet and lifestyle to support healing.
Prognosis:

Shoulder replacement surgery can provide long-term pain relief and functional improvement for many patients. The success of the procedure depends on various factors, such as the patient’s age, overall health, adherence to rehabilitation, and the underlying condition being treated. Most individuals experience a significant reduction in pain and improved shoulder function after recovery.

When to Consult a Doctor:

After shoulder replacement surgery, it is essential to monitor the recovery progress and promptly consult a doctor if any of the following occur:

  • Increased pain or swelling in the shoulder
  • Persistent fever
  • Difficulty moving the arm or shoulder
  • Redness, warmth, or discharge from the incision site
FAQs:
  1. How long does a shoulder replacement last? The durability of shoulder replacements varies, but they can typically last for 15 to 20 years or longer, depending on factors such as patient age, activity level, and the type of implant used.
  2. Can I drive after shoulder replacement surgery? Driving restrictions may vary depending on the surgical approach, the side of the surgery, and individual recovery progress. It is crucial to consult the surgeon and follow their specific guidelines regarding driving.
  3. Can I participate in sports or physical activities after shoulder replacement surgery? Engaging in sports or physical activities after shoulder replacement surgery should be discussed with the surgeon. While some activities may be possible, high-impact or contact sports that involve repetitive overhead motion may need to be avoided.