Your shoulders are ball-and-socket joints that get a lot of use. When they are not working quite right, pain shows up. Sometimes, the pain doesn’t go anywhere until you’re ready to do something about it.
If your doctor mentions the possibility of shoulder replacement surgery, you might cringe. As the conversation goes on, however, it doesn’t sound nearly as scary.
You learn that shoulder replacement – or more accurately, shoulder arthroplasty – involves replacing damaged parts of the shoulder with artificial components.
There are different kinds of procedures based on the severity and type of damage causing the problems. Often, recovery and rehab are not as disruptive as you might anticipate, and once completed, your shoulder’s flexibility is better than you can remember.
“Three months after surgery, my shoulder patients tell me they regret putting it off as long as they did,” said Clint Benge, M.D., a Sanford Health orthopedic surgeon in Sioux Falls, South Dakota, who does shoulder procedures. “They are recovering quicker than they thought. Strength and range of motion is returning, and the pain is no longer there.”
Qualifying for shoulder replacement surgery
Shoulder replacement surgery should be considered when severe, persistent pain and a lack of mobility have not responded to other treatments.
These procedures are most often recommended for:
- Osteoarthritis or rheumatoid arthritis: The cartilage in the joint breaks down, leading to pain and stiffness.
- Severe rotator cuff tears: A damaged rotator cuff causes pain and restricts shoulder function.
- Serious shoulder injury: Fractures that do not heal correctly and may lead to permanent limited shoulder use.
Shoulder replacement may also be recommended for avascular necrosis, a condition where the bones don’t get enough blood.
At the core of needing a shoulder replacement are two symptoms: a lack of mobility in the shoulder and an abundance of discomfort.
“Whether they have been limiting themselves to avoid pain or they just don’t have good functionality of motion, a lot of times our shoulder patients are in some pain all the time,” Dr. Benge said. “They might not even realize how limited they are because it’s been going on so long. The shoulder replacement can get them back to doing things they haven’t done in several years.”
Types of shoulder replacement procedures
Shoulder replacement surgery options depend on what is causing the problem and the extent of damage and wear on your shoulder.
The three types of shoulder replacements Sanford Health offers are:
- Total shoulder replacement. Also known as a total shoulder arthroplasty, this procedure replaces the end of your upper arm bone and the cup-shaped part of your scapula with artificial components, restoring proper function to the shoulder joint.
- Partial shoulder replacement. This procedure removes the damaged section of your shoulder joint and replaces it with an artificial component.
- Reverse total shoulder replacement. This procedure replaces both parts of your shoulder joint but reverses the natural location of them, meaning the ball end is attached to your scapula and the cup end is on your upper arm. This can be beneficial for patients who have a torn or damaged rotator cuff.
Though the reverse total shoulder replacement sounds a little scary, Dr. Benge calls it “a very good answer to a bad problem. With a traditional total replacement your rotator cuff has to be intact. With the reverse, we don’t need an intact rotator cuff for good functionality of the shoulder. It’s been a great solution for a patient population that we really couldn’t help before.”
More prevalent, more effective
Shoulder replacement procedures are an increasingly common way of addressing chronic shoulder pain. Though published statistics vary widely, the Journal of Shoulder and Elbow Surgery forecasts as many as 350,000 shoulder replacement surgeries will be performed in the U.S. in 2025. This would represent a 235% increase since 2017.
An aging population explains some of the increase, but advances in surgical techniques are also playing a role in patients’ decision-making process. What was once perceived as an intricate procedure with a delicate recovery is now viewed as a no-nonsense way to get back in the game.
“Over the years, design changes and the understanding of how the components work has improved quite a bit,” Dr. Benge said. “With some changes in rehab protocol, we’ve actually found that getting people back into things quicker really improves outcomes long-term.”
After surgery and beyond
The procedure normally includes general anesthesia and takes a few hours to complete. Most patients will leave the hospital within a day or two of the procedure, although some may be able to go home the same day as their operation.
The recovery process typically lasts a few months to a year. Follow-up visits will begin within a few weeks of surgery and are scheduled periodically based on recommendations of a Sanford Health care team that often includes physical and occupational therapists. During this time, it is important for patients to follow their recovery instructions and report any concerns to their provider.
“Depending on which type of replacement we go with, it’s somewhere between four to six weeks in a sling,” Dr. Benge said. “We want to let the tissues calm down, then start the therapy at the two-week mark. I’d say across the board, patients are able to put their arm overhead by themselves in three months.”
Dr. Benge recommends therapy for three or four months after surgery. At the six-month mark, most of his patients are back to doing everything they want at nearly full strength and flexibility. A year after surgery, patients have a new normal that now includes a lot of things they couldn’t do before their surgery.
“In that first conversation with a patient, we spend a lot of time dispelling some of the stigma for what a shoulder replacement is going to be,” Dr. Benge said. “They’re thinking they’re going to be pretty laid up and not able to do much. But long-term, it’s actually the opposite – we’re going to do this so we can get people back to doing the things they really want to do.”
Is it time to consider shoulder replacement surgery?
If you suffer from shoulder pain or struggle with your joint function, shoulder replacement surgery may be the best way for you to get relief.
Sanford orthopedic surgeons and specialists offer a variety of shoulder replacement options for patients of all ages. They can walk you through the entire treatment process so you can recover safely and effectively.
Learn more
- Old injuries prompt retired NFL quarterback to seek relief
- What to know about total joint replacement surgery
- What you need to know about joint pain
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Posted In Orthopedics, Sioux Falls, Sports Medicine
