How the Normal Shoulder Works
- The shoulder is a ball-and-socket joint that enables you to raise, bend and twist your arm. It also lets you move your arm forward, to the side and behind you.
- In a normal shoulder, the rounded end of the upper arm bone (head of the humerus) glides against the small dish-like socket (glenoid) in the shoulder blade (scapula).
- These joint surfaces are normally covered with smooth cartilage and allow the shoulder trotate through a greater range of motion than any other joint in the body.
Common Causes of Shoulder Pain and Loss of Shoulder Function
- Osteoarthritis usually occurs after age 50, often in an individual with a family history of arthritis. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against each other, causing pain and stiffness.
- Rheumatoid Arthritis is a disease in which the synovial membrane becomes thickened and inflamed, producing tomuch synovial fluid that over-fills the joint space. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain and stiffness.
- Post-Traumatic Arthritis can follow a serious shoulder injury. A fracture or severe tears of the ligaments may damage the cartilage over time, causing pain and limiting shoulder function.
- Rotator Cuff tear arthropathy is a combination of severe arthritis and a massive non-reparable rotator cuff tendon tear.
- Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply tthe bones. When it occurs near a joint, it can lead to collapse of the joint surface.
- Severe fractures
Realistic Expectations about Shoulder Replacement Surgery
- An important factor in deciding whether thave total shoulder replacement surgery is understanding what the procedure can and can't do.
- More than 90 percent of individuals who under go total shoulder replacement experience a dramatic reduction of pain and a significant improvement in the ability tperform common activities of daily living. But total shoulder replacement won't make you a super-athlete or allow you to do more than you could before you developed arthritis.
- Following surgery, you will be advised tavoid some types of activity.
- With normal use and activity, every joint replacement develops some wear in its plastic cushion. Excessive activity or weight may accelerate this normal wear and cause the joint replacement to loosen and become painful. With appropriate activity modification, joint replacements can last for many years.
- The surgical procedure takes one to two hours depending on the type of replacement. Your orthopaedic surgeon will remove the damaged cartilage and bone, and then positions the new metal and plastic joint surfaces trestore the alignment and function of the shoulder.
- There are many different types of shoulder replacements and the one your orthopaedist chooses depends on the age and activity level of the patient and the type of arthritis he or she has.
- Many cases of osteoarthritis require replacement of the ball (humeral head) with a metal implant and resurfacing of the socket (glenoid) with a plastic component.
- In the case of rotator cuff arthopathy, a reverse shoulder replacement is necessary timprove pain and function. A metal ball is placed on the socket side and the ball of the arm is converted into a socket in this procedure.
- In the young, active patient bone sparing procedure called a shoulder resurfacing can be performed. This type of procedure preserves and improves function without removing the ball of the arm joint. Additionally, the socket is not resurfaced.
- Often, nbone cement is used for many of these procedures.
- After surgery, you will be moved to the recovery room where you will remain for one to two hours while your recovery from anesthesia is monitored. After you awaken fully, you will be taken to your hospital room.