Shoulder Replacement

Shoulder Replacement Surgery in NYC

Treatment OptionsShoulder replacement surgery illustration

In order to determine whether shoulder replacement surgery is the best option to relieve pain and improve shoulder function, Dr. Mendoza, top NYC shoulder surgeon, will first take a complete medical history and do a thorough physical examination to assess family history and past injuries. Through physical examination, the doctor will be able to evaluate pain level, range of motion and muscle strength. In addition, further testing such as X-rays, MRI scans or a bone scan may be required in order to determine the condition of the bone and soft tissues in the shoulder. If shoulder replacement surgery is deemed necessary, Dr. Mendoza will assess which type of replacement surgery will prove most effective for the patient’s unique circumstance.

Types of Shoulder Replacement Procedures

There are several types of shoulder replacement surgeries.

Total Shoulder Arthroplasty

Performed to treat arthritis of the glenohumeral joint, this procedure, also called shoulder joint replacement, involves replacing both the ball and socket of the shoulder joint.

Hemiarthroplasty

This surgical procedure, also used to treat arthritis of the glenohumeral joint, involves a replacement of the head (ball) of the humerus.

Reverse Total Shoulder Arthroplasty

Performed to treat arthritis of the glenohumeral joint associated with degenerated rotator cuff tendons, this procedure, also called reverse total shoulder replacement, involves the socket and ball being switched so that the ball is attached to the shoulder bone and the socket is attached to the upper arm bone.

In cases where nonsurgical treatment options and activity modifications are no longer helpful with relieving shoulder pain caused by arthritis, severe fractures or other conditions, shoulder replacement surgery may be recommended. This safe and effective shoulder surgery will help relieve pain, improve motion and strength, and enable patients to resume everyday activities with a better functioning shoulder. While not as common as knee or hip replacement, there are more than 50,000 shoulder replacement surgeries performed in the U.S. each year.Bones of the Shoulder

Anatomy of the Shoulder

There are three bones in the shoulder: the clavicle or collarbone, the proximal humerus or top of the arm bone, and the scapula or shoulder blade. There are also four joints where these bones connect: the glenohumeral joint, acromioclavicular joint, sternoclavicular joint and the scapulothoracic joint. The ball and socket arrangement of the shoulder enables a wide range of motion. It also, unfortunately, includes a complex arrangement of bones, muscles and ligaments that may be damaged.

Causes for Shoulder Replacement

There are several conditions that can lead patients to consider shoulder joint replacement surgery.

Osteoarthritis

The most common type of shoulder arthritis is osteoarthritis, or degenerative joint disease. This occurs when the cartilage, which normally acts as a protective cover for the bones, degenerates. Without this cartilage to act as a buffer, the affected bones rub against one another, wearing each other down and resulting in pain and swelling. Sometimes, this friction also results in the development of bone spurs which are painful and interfere with movement.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease. In rheumatoid arthritis, the lining of the joints as well as the cartilage is affected, causing painful swelling and redness and potentially resulting in bone erosion and even deformity of affected joints. Unlike osteoarthritis, RA may cause symptoms of fever and fatigue and is a symmetrical disease, usually affecting the same joint on both sides of the body. Another distinction is that in rheumatoid arthritis, stiffness and pain occur even at rest, whereas with osteoarthritis the symptoms are more apparent with movement than after periods of rest.

Post-traumatic Arthritis

Post-traumatic arthritis is a form of osteoarthritis that develops after a traumatic injury, such as a fracture or dislocation of the shoulder, and may occur at any age.

Avascular Necrosis

Avascular necrosis (AVN) occurs when the blood supply to the ball (humeral head) at the top of the arm bone is interrupted. AVN can ultimately lead to the death, or necrosis, of the bone cells in the humeral head and may eventually result in shoulder arthritis. In addition to occurring after injury, AVN may be caused by alcoholism or use of steroids.

Severe Shoulder Fractures

A severe shoulder fracture is another common reason to undergo shoulder replacement surgery. This is especially typical among older patients with osteoporosis as they are at a higher risk for severe shoulder fractures. If the head of the upper arm bone is shattered, it can be very difficult for a doctor to repair. The blood supply to the bone pieces can also be interrupted, presenting additional complications. In cases like these, a shoulder replacement surgery may be the only option to restore the shoulder’s proper function and range of motion.

Reasons for Shoulder Replacement

There are several reasons why a shoulder replacement surgery may be recommended. Patients who will benefit from the surgery may be experiencing:

  • Loss of motion or weakness in the shoulder
  • Severe shoulder pain that interferes with everyday activities
  • Moderate to severe shoulder pain while resting, which may interfere with sleep

Patients who have not shown improved symptoms with nonsurgical treatment options such as anti-inflammatory medications, physical therapy or cortisone shots are typically good candidates for shoulder replacement surgery.