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Christian T. Andersen, MD

Daniel W. Bienkowski, MD

Sohail N. Husain, MD

Sameer O. Kapasi, MD

Erika McPhee, MD

Ashley Rogerson, MD

Abraham T. Shurland, MD

Marie Walcott, MD

Evan J. Zahner, MD

Craig Lehmann, PA-C

Krista Reis, PA-C

Thomas Walsh, PA-C

Randy Widtfeldt, PA-C

Diane Fiore, OTR/L, CHT

Christy Wright, OTR/L, CHT

James Knowles, DPT

Caitlin Tassone, DPT

Kathleen Bannon, PT

Craig Hansen, PT

Alyssa L. Evans, PTA

Travis Gomes, PTA

Lauren Hromada, PTA, ATC

Julie Robbio, PTA

Maggie MacKillop, PTA

Erica Rotondo, PTA

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Total Shoulder Replacement:  What Should I Expect?

by Marie Walcott, MD

Marie Walcott, MD

Total Shoulder Replacement has helped an increasing number of patients regain shoulder function and live with minimal pain. Total Shoulder Replacement is far less common than hip or knee replacement, but it is growing at twice the rate of knee replacements. After Total Shoulder Replacement, patients often experience a marked reduction in their pain, improved range of motion and greater strength.  In our experience, patients who have had years of pain and limited mobility are often able to return to activities, like golf, that they have been unable to do for years before shoulder replacement.   As an orthopedic surgeon who is fellowship trained in the shoulder, including Total Shoulder Replacement, I feel it is very important for patients to educate themselves about their shoulder condition and treatment options, which are not always surgical.

Advanced arthritis is one of the primary reasons that someone would be a candidate for a Total Shoulder Replacement. Patients with shoulder arthritis typically experience a gradual onset of a dull ache in their shoulder and have stiffness.  Often, patients feel grinding, clicking, or even catching of their shoulder.  This lack of shoulder mobility can lead to a loss of function. Arthritis of the shoulder can make reaching over your head or behind your back painful and even impossible as the condition progresses.  In the advanced stages of shoulder arthritis, patients may actually be awakened at night by the pain. 

Before taking the big step towards having a Total Shoulder Replacement, it is important that patients do everything they can to improve their shoulder without surgery. I will work closely with each patient to obtain relief through non-surgical interventions that may include activity modification, physical therapy, medications, and cortisone injections. 

The shoulder is a ball-and-socket joint made up of the ball side (the humerus, which is the bone in your arm) and the cup side (the glenoid, which is part of your shoulder blade).  With a Total Shoulder Replacement, the ball side (the humeral head) is replaced with a metal ball, usually cobalt/chrome or titanium and the cup side (the glenoid) is replaced with a polyethylene plastic. After the joint it replaced, the new joint is made of the metal ball moving smoothly in with the plastic cup.

The rotator cuff muscles are important with normal shoulder function and continue to be important after Total Shoulder Replacement. The rotator cuff muscles start on the shoulder blade and connect to the top of the humerus and perform the important functions of stabilizing and moving the shoulder. After a Total Shoulder Replacement, they continue to be very important allowing patients to regain their motion and strength.  As with the all shoulders, the stability of the replaced shoulder will be dependent on the function of the rotator cuff. The rotator cuff is so important to shoulder function that in patients with arthritis and a rotator cuff is tear a different treatment may be necessary.

There are certain circumstances, such as patients with rotator cuff tears and arthritis or with severe shoulder fractures, when I would recommend a different type of shoulder replacement. It is called a Reverse Shoulder Replacement. In this type of shoulder replacement, the location of the ball and socket are switched. The socket is placed on the ball-side and the ball is placed on the socket-side. By switching the location of the ball-and-socket, other muscles around the shoulder can do the job of the torn rotator cuff.

If you would like to learn more and discuss if these procedures are right for you, please do not hesitate to contact our office.  It will be my pleasure to do whatever I can to return your shoulder function.  Please feel free to visit our website at www.agilitydoctor.com to learn more about Agility Orthopedics.