Shoulder Replacement Surgery

What is Shoulder Replacement Surgery?

Shoulder replacement surgery (shoulder arthroplasty) involves replacing damaged parts of the shoulder joint with prosthetic components. The shoulder is a ball-and-socket joint where the head of the humerus (upper arm bone) fits into a shallow socket in the scapula (shoulder blade). During replacement surgery, the damaged humeral head is replaced with a metal ball attached to a stem, while the socket may be resurfaced with a plastic or metal and plastic component. This procedure is typically performed to relieve pain and restore function in shoulders damaged by various forms of arthritis, severe fractures, or other degenerative conditions.

When Is Shoulder Replacement Recommended?

Dr. Saxena may recommend shoulder replacement surgery for patients experiencing:

• Severe shoulder pain that interferes with daily activities
• Moderate to severe pain while resting, particularly at night
• Loss of motion or weakness in the shoulder
• Failure to improve with conservative treatments like medications, injections, or physical therapy
• Advanced osteoarthritis (degenerative joint disease)
• Rheumatoid arthritis causing severe joint damage
• Post-traumatic arthritis following a severe shoulder injury
• Complex fractures of the shoulder that cannot be reconstructed
• Avascular necrosis (death of bone tissue due to limited blood flow)
• Rotator cuff tear arthropathy (a combination of severe arthritis and a massive rotator cuff tear)
• Failed previous shoulder replacement surgery (revision surgery)

Types of Shoulder Replacement Procedures

Dr. Abhishek Saxena specializes in various shoulder replacement techniques, tailoring the approach to each patient's specific condition:

• Total Shoulder Replacement: Both the ball (humeral head) and socket (glenoid) are replaced with prosthetic components. Ideal for patients with intact rotator cuff muscles and osteoarthritis.
• Partial Shoulder Replacement (Hemiarthroplasty): Only the ball portion of the joint is replaced, leaving the natural socket intact. This may be recommended for certain fractures or when the socket cartilage is healthy.
• Reverse Total Shoulder Replacement: The ball and socket positions are reversed, with the ball attached to the shoulder blade and the socket attached to the upper arm. This revolutionary design is particularly effective for patients with rotator cuff tear arthropathy or failed conventional replacement.
• Stemless Shoulder Replacement: Uses an implant that doesn't extend down the arm bone's shaft, preserving more bone stock and allowing for easier revision if needed in the future.
• Revision Shoulder Replacement: Surgery to replace a previous shoulder implant that has worn out, become loose, infected, or is causing complications.

Our Advanced Surgical Approach

Dr. Saxena utilizes the latest techniques and technologies in shoulder replacement surgery:

• Preoperative 3D planning using CT scans for precise implant positioning
• Patient-specific instrumentation for optimal implant placement
• Minimally invasive techniques when appropriate to reduce muscle damage
• Advanced bearing surfaces that maximize implant longevity
• Augmented glenoid components for patients with significant bone loss
• Innovative fixation methods for secure implant attachment
• Intraoperative nerve monitoring for enhanced safety

The Surgical Experience

Shoulder replacement surgery typically takes 2-3 hours and is performed under general anesthesia, often combined with a regional nerve block for postoperative pain control. Most patients require a hospital stay of 1-2 days.

During the procedure, Dr. Saxena makes an incision (typically 4-6 inches) at the front of the shoulder to access the joint. After carefully protecting surrounding nerves and blood vessels, the damaged bone surfaces are prepared, and the appropriate prosthetic components are precisely positioned. The incision is closed with sutures, and a sterile dressing is applied.

Recovery and Rehabilitation

Recovery from shoulder replacement surgery is a gradual process that typically follows this timeline:

• Immediate Post-Surgery (0-6 weeks): Arm is kept in a sling for protection, with passive motion exercises beginning within days of surgery under the guidance of a physical therapist. Pain management is a priority during this phase.
• Early Recovery (6-12 weeks): Progressive transition to active motion exercises as healing progresses. The sling is gradually discontinued, and strengthening exercises are introduced.
• Intermediate Recovery (3-6 months): Focus shifts to strengthening the shoulder muscles and improving functional use of the arm for daily activities. Most patients experience significant pain relief by this stage.
• Long-term Recovery (6+ months): Continued improvement in strength and function, with many patients able to resume light recreational activities. Maximum improvement may continue for up to a year after surgery.

Our comprehensive rehabilitation protocol is tailored to each patient's specific needs and type of replacement performed. Regular follow-up appointments with Dr. Saxena ensure optimal healing and functional recovery.

Long-Term Outcomes and Expectations

Modern shoulder replacement surgery has an excellent track record of success. Most patients can expect:

• Significant reduction or elimination of shoulder pain
• Improved range of motion and function
• Enhanced quality of life and independence
• High satisfaction rates (over 90% in most studies)
• Durable results with many implants lasting 15-20 years or longer

After recovery, most patients can comfortably perform daily activities such as dressing, grooming, and household tasks. While high-impact activities and heavy lifting are generally discouraged to protect the implant, many patients can enjoy swimming, golf, doubles tennis, and other low-impact recreational activities.