SHOULDER
That is the response of many patients I talk to about shoulder replacement. Most people know someone who has had a knee or a hip replacement but shoulder replacements are becoming more common. Currently, shoulders are the third most common joint replaced.
The shoulder is made up of three bones: the arm bone (humerus) which has a ball at the top end (humeral head), the shoulder blade (scapula) that has the socket of the shoulder (glenoid), and the collar bone (clavicle). The shoulder joint is a ball and socket joint. In the shoulder, the ball (humeral head) is larger than the socket (glenoid) so it is actually more like a golf ball sitting on a golf tee. The rotator cuff is the four muscles around the shoulder that help the ball (humeral head) rotate in the socket (glenoid), moving the arm.
Shoulders are usually replaced when you have arthritis, which is a wearing down or loss of cartilage in the shoulder. Many people also get bone spurs as the arthritis progresses. The loss of cartilage and the bone spurs can make the shoulder painful and stiff. Shoulder replacements remove the arthritic bone and replace it with metal and plastic. This will treat the pain and give you better shoulder motion.
There are three main types of shoulder replacement.
1. The most common replacement is a total shoulder replacement. With a total shoulder replacement, a metal ball replaces the humeral head and the glenoid (or socket) is resurfaced with plastic. Most patients with total shoulder replacements have good pain relief after surgery.
2. Another type of shoulder replacement is a reverse shoulder replacement. In a reverse shoulder replacement, a metal ball is put on the glenoid (or socket) and a metal and plastic socket replaces the humeral head - the orientation is "reversed." Besides improving pain, a reverse shoulder replacement allows you to get your arm overhead even if your rotator cuff is torn.
3. A less common type of shoulder replacement is when only the humeral head is replaced with a metal ball. This is sometimes used when the humeral head is broken in a fall or accident and can’t be put back together.
If you are a candidate for shoulder replacement, your surgeon will discuss which shoulder replacement option is best for you. Although all surgery carries risk, shoulder replacement can provide significant pain relief and improved shoulder motion in people with painful arthritis of the shoulder.
Ana Mata-Fink, MD
