What Are the Conditions Requiring a Total Shoulder Replacement?
Shoulder arthritis is becoming a more common issue today as people remain much more active throughout their lives.
We’ve seen knee replacements and hip replacements for knee and hip arthritis. Shoulder replacement is not done as often as knee and hip replacements, but we’re starting to see it more and more.
For patients with severe arthritis or neglected rotator cuff tears, shoulder replacement can be an excellent option to improve pain and optimize function.
Total shoulder replacement is recommended when conservative, non-surgical options (such as PRP) are no longer viable options and you want to improve pain and function.
Total Shoulder Replacement vs. Reverse Shoulder Replacement
Whether someone is a candidate for a total shoulder replacement or a reverse shoulder replacement really depends upon two things:
- The pattern of arthritis.
- Whether the rotator cuff is intact and functioning.
In the event that the rotator cuff is intact, a total (anatomic) shoulder replacement is my preference for patients.
Total shoulder replacements can typically be done in an outpatient setting.
To decide which shoulder replacement option is appropriate for you, I would need to evaluate your MRI and conduct an examination.
The good news is that both total and reverse shoulder replacements perform very well, and there is a high degree of patient satisfaction.
When Should You See a Shoulder Specialist?
Anytime you are dealing with a shoulder issue, it’s a good idea to see a shoulder specialist. The shoulder is a complex joint, and not every treatment is appropriate for everybody. Being able to go through various treatment options with someone who treats the whole spectrum of shoulder disorders is always a good idea.
The truth is that most patients are not surgical candidates,.. They typically require more conservative treatment options such as:
- Physical therapy
- Anti-inflammatories
- Activity modification
- Inections (cortisone or PRP)
However, when shoulder problems become more complex and injections or surgical treatments may become necessary, discussing your case with a shoulder specialist is a good place to begin.
What to Expect at Your First Shoulder Consult?
I like to begin with a conversation, just getting to know you, and then learning more about things that will impact treatment options like:
- What are some of the things that you do vocationally and recreationally?
- What are your overall activity levels?
- Are there things that you are trying to get back to?
- What are some things that you are unable to do?
- How long have you been unable to do those things?
- Have you tried any other treatment options?
I always conduct an examination and review any imaging you may have had in the past, such as x-rays or MRIs. If there has not been any imaging completed already, I will most likely place an order for that.
Once I have the opportunity to get to know you and the outcomes you’re hoping for, we can take the next steps in tailoring treatment options that best align with your goals. Whether it’s improving your quality of life, having you be able to engage in activities again, returning to sports, or just being able to sleep again without pain, we’ll work together to get you there.
I like to consider the whole spectrum of treatment options for shoulder disorders:
- Observation/Reassurance
- Anti-inflammatory medications
- Physical therapy
- Injections of cortisone
- Biologic treatments (PRP or BMAC)
- Surgical treatment if appropriate
In considering all of these options in conjunction with where you are physically and the outcomes you are hoping for, we can put together a plan tailored to maximize your possible results.
Shoulder Replacement Surgery: What to Expect
Preoperatively, we’ll sit down together and have a conversation about what to expect on the day of surgery, what to expect in the days immediately after surgery, how long rehabilitation is expected to take, and what benchmarks we are hoping for.
I think really understanding the expectations is critical to my patients having good outcomes. When you know what goals you should be achieving, what feelings are normal and abnormal, you are best set up for a successful recovery.
Most importantly, my patients have a direct line to me, even after surgery, for any questions that may come up.
If you are experiencing shoulder problems and would like to schedule an appointment with me, please click here.
Do you have more questions relating to shoulder surgery? Click here to see some of the most frequently asked questions I receive.