Avascular Necrosis (Osteonecrosis)
Osteonecrosis is loss of blood supply to the bones. Without blood, the bone tissue dies and the bone structures collapse, resulting in pain and loss of function.
Chronic steroid use, deep sea diving, severe fracture of the shoulder, sickle cell disease and heavy alcohol use are risk factors.
A shoulder joint replacement is an effective treatment for osteonecrosis. Talk with your doctor to see if shoulder replacement is the best option for your condition.
Failed Previous Shoulder Replacement Surgery
Although uncommon, some shoulder replacements fail, most often because of implant loosening, wear, infection or dislocation.
When this occurs, a second joint replacement – called a revision surgery – may be necessary.
An experienced orthopedic surgeon is your best resource to explore whether another shoulder replacement surgery is your best option.
Osteoarthritis (Degenerative Joint Disease)
Osteoarthritis is the most common type of arthritis. This degenerative joint disease occurs when the cartilage that cushions the end of the bones gradually wears away. The bones begin to rub against each other, leading to irritation, swelling, stiffness and pain.
Shoulder joint replacement surgery is an effective treatment for serous osteoarthritis of the shoulder. Talk with your doctor about whether surgery is a good choice for you.
Fractures of the bones that make up the shoulder or tears of the shoulder tendons or ligaments damage the articular cartilage over time, causing pain and loss of function.
This type of arthritis, known as post-traumatic arthritis, can effectively be treated with a shoulder joint replacement. An experienced orthopedic surgeon can help you determine if joint replacement surgery is a good choice for your condition.
A resurfacing hemiarthroplasty is a type of shoulder joint replacement surgery.
This procedure involves replacing the joint surface of the humeral head with a cap-like prosthesis. With its bone-preserving advantage, resurfacing hemiarthroplasty offers patients with arthritis an alternative to standard stemmed shoulder replacement.
It also avoids the risks of component wear and loosening that may occur with conventional total shoulder replacements over time.
Reverse Total Shoulder Replacement
In reverse total shoulder replacement, the ball and socket are switched. A metal ball is attached to the scapula and a plastic socket is attached to the humerus.
Once the location of the ball and socket are reversed, patients use their deltoid muscle, instead of their rotator cuff, to lift their arm overhead.
Candidates for reverse total shoulder replacement may include patients with:
- Rotator cuff tear arthropathy
- No range of motion in the shoulder joint
- Severe shoulder fractures
- Failed shoulder replacements
With rheumatoid arthritis, a person's immune system mistakenly attacks itself and causes the joint lining to swell. The inflammation spreads to the surrounding tissues, and can eventually damage cartilage and bone.
Shoulder joint replacement surgery can be an effective treatment when rheumatoid arthritis has seriously impaired the shoulder joint. Talk with your doctor to see if shoulder joint replacement surgery is an appropriate treatment for your rheumatoid arthritis.
Rotator Cuff Tear Arthropathy
Individuals with rotator cuff tear arthropathy experience changes in the shoulder joint that can lead to arthritis and destruction of the joint cartilage.
Shoulder joint replacement surgery can be an effective treatment with rotator cuff tear arthropathy. Your orthopedic surgeon can determine if shoulder joint replacement surgery is appropriate for you.
When the head of the humerus is shattered, it may be difficult to put the pieces of bone back in place. In addition, blood supply to the bone pieces can be interrupted from these types of severe fracture.
Shoulder joint replacement surgery may be an appropriate treatment for a severely broken shoulder. Talk with your doctor to see if you would benefit from replacement surgery.
Depending on the condition of your shoulder, your surgeon may replace only the head of the humerus with a metal ball and stem, similar to the component used in a total shoulder replacement.
Stemmed hemiarthroplasty is recommended when:
- The humeral head is severely fractured or arthritic, but the socket is normal
- There is rotator cuff tear arthropathy and a total shoulder replacement would likely fail over time
Consult with an experienced orthopedic surgeon who performs shoulder joint replacement so see if a stemmed hemiarthroplasty is an appropriate surgery for your condition.
Total Shoulder Replacement
The typical total shoulder replacement involves replacing the arthritic or otherwise damaged joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket.
The components used in shoulder replacement surgery come in various sizes. They may be either cemented or press fit into the bone.
Patients with osteoarthritis and intact rotator cuff tendons are generally good candidates for a total shoulder replacement. Talk with your physician to learn if this surgical procedure meets your needs.