Your shoulder is one of the most-often-used joints in your body, used in countless activities throughout the course of day-to-day life, from work to play to driving a car. It’s a complex ball-and-socket joint, connecting your upper arm and shoulder blade, that involves muscle, cartilage, tendons, and bones, each of which performs an important function.
When you sustain damage or injury to the cartilage that cushions your shoulder joint, the bones can rub together, leading to stiffness, swelling, and significant pain. In many instances, your discomfort can be minimized or alleviated with non-invasive procedures, such as physical therapy, medication, injections, or changes in your physical activities. However, when those fail, you may need to consider replacing the ball and socket, a procedure referred to as “total shoulder replacement.” As a general rule, your doctor will consider total shoulder replacement as a last option, typically only when your shoulder pain prevents you from engaging in basic daily activities or doesn’t go away with adequate rest.
To confirm that total shoulder replacement is necessary, your physician will conducta thorough physical exam and also might order X-rays or an MRI (magnetic resonance imaging).
The Shoulder Replacement Procedure
Total shoulder replacement is a major surgical procedure, usually requiring general anesthesia. The surgeon makes an incision on the top of the affected shoulder so that the underlying muscles can be moved to expose the shoulder joint. The ball (upper arm bone) is then pulled out of the socket (shoulder blade) and removed. The remaining upper arm bone is hollowed out and filled with a cement. A new metal ball with a stem is then inserted into the hollowed-out area and held in place by the cement.
You can expect to have your shoulder and arm immobilized for a significant period of time, and you may need to wear a cast or sling for weeks or months. Your doctor is likely to start you on a gentle physical therapy regimen shortly after the procedure.