Shoulder Replacement Frequently Asked Questions

The shoulder is the most mobile joint in the human body with a complex arrangement of bone and soft tissue (ligaments, tendons, and muscles) that work together to produce shoulder movement. Click here for more information.
Glenohumeral (shoulder) joint arthritis is caused by the destruction of the cartilage layer covering the bones in the glenohumeral joint. This creates a bone-on-bone environment, which encourages the body to produce osteophytes (bone spurs). Click here for more information.
The labrum is a disk of cartilage on the glenoid, or “socket” side of the shoulder joint. The labrum helps stabilize the joint and acts as a “bumper” to limit excessive motion of the humerus, the “ball” side of the shoulder joint. Click here for more information.
A diagnosis of glenohumeral arthritis is made after a physician will take the patient’s history from the past several years and perform a physical examination. IX-rays of the shoulder can confirm a diagnosis. Other imaging techniques include a CT-Scan, Arthrogram, and MRI. Click here for more information.
Shoulder arthritis can often be managed with rest, non-steroid anti-inflammatory medications, and exercises to increase range of motion and strength. In some cases corticosteroid injections, glucosamine and chondroitin supplements, and viscosupplementation therapy are helpful. Click here for more information.
Operative procedures to treat glenohumeral arthritis include debridement and shoulder arthroplasty (replacement). Click here for more information.
In debridement, the physician smoothes the damaged articular cartilage to ease the pain and symptoms associated with the mechanical effects of arthritis (locking, catching, and popping). Debridement may provide temporary pain relief, but does not stop cartilage destruction, which is the primary cause of arthritis pain. Click here for more information.
A total shoulder arthroplasty (replacement) involves the replacement of both sides of the glenohumeral joint (the humerus and the glenoid). A hemiarthroplasty replaces the humeral head only, and is the treatment of choice when replacement of the glenoid is not advised. The surgeon will recommend a procedure based upon the nature and degree of the patient’s arthritis. Click here for more information.

Even with the closest attention to detail, surgical complications may occur. Debridement surgery is typically less complex than arthroplasty. However, as with arthroplasty, the potential complications of bleeding, nerve injury, and infection are present. Other common complications include: infection, blood loss, nerve injury, and component failure. 

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During the first six to eight weeks the shoulder is immobilized with a sling. During this this time physical therapy will begin and continue until a return to full activity is obtained, usually within four to six months. Click here for more information.
Shoulder arthroplasty is a complex procedure, which requires a great amount of cutting of deep tissues and bone. The surgeon takes great care to eliminate pain with appropriate analgesia both immediately after surgery and during the rehabilitation process. A long acting local anesthetic infused around the nerves of the joint is often used with general anesthesia during surgery. These regional blocks will provide several hours of pain relief even after a patient has emerged from general anesthesia. A patient-controlled intravenous infusion pump (PCA) is used in the early postoperative period for pain control. By the second or third day after surgery, oral pain relief medication is adequate through the early rehabilitation period (4-6 weeks). Click here for more information.
The time it takes to return to normal activity varies greatly from patient to patient. Most individuals have less pain at night or at rest in the first 2-4 weeks after surgery. Pain with activity persists longer, but generally decreases as the strength and function of the shoulder muscles improve. Full recovery usually takes 4-6 months. Click here for more information.
Long-term studies show that 85-90% of total shoulder replacements are functioning well ten years after implantation, and 75-85% are doing well fifteen years after surgery. Over time, current advances in materials and techniques should improve these percentages even more. Click here for more information.

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