Total shoulder joint replacement for shoulder arthritis: Surgery with a dependable, time-tested conservative prosthesis and accelerated rehabilitation can lessen pain and improve function in shoulders with arthritis.

Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Wednesday, May 14, 2008

Figure 1 - This is a humeral head in situ that has been damaged by arthritis.

Figure 2 - Humeral implant

Summary

What are the key points about shoulder replacement surgery for shoulder arthritis?

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Total shoulder replacement surgery (arthroplasty) helps restore comfort and function to shoulders damaged by degenerative joint disease, osteoarthritis, or rheumatoid arthritis.

In shoulder arthritis the joint surface is destroyed by wear and tear, inflammation, injury, or previous surgery. Figure 1 shows the surface of a ball of the shoulder joint (humeral head) which has been destroyed by arthritis. This joint destruction makes the shoulder stiff, painful and unable to carry out its normal functions.

After performing a clinical exam, a shoulder surgeon experienced in joint replacement can find out if arthritis is the cause of the problem and if surgery would be helpful. Patients are most likely to benefit from this surgery if they are well motivated and in good health.

The goal of shoulder replacement arthroplasty is to restore the best possible function to the joint by removing scar tissue, balancing muscles, and replacing the destroyed joint surfaces with artificial ones.

Figure 2 shows the artificial components including the humeral ball (which is made of metal) and the glenoid component (which is made of plastic). The humeral ball is fixed to the humerus (arm bone) with the humeral stem. The glenoid component is fixed to the shoulder blade using a small amount of bone cement.

Total shoulder joint replacement arthroplasty is a highly technical procedure and is best performed by a surgical team who performs this surgery often. Such a team can maximize the benefit and minimize the risks. The two-hour procedure is performed under general (or nerve block) anesthesia.

Shoulder motion is started immediately after the procedure. Patients learn to do their own physical therapy and are usually discharged three days after surgery if they are comfortable and have a good range of passive motion. The recovery of strength and function may continue for up to a year after surgery.

• Lowell North sails away with new shoulder (uwnews.org)

• JBJS Article on Total Shoulder Arthroplasty (PDF) (0.8 MB)

• JBJS Article on Hemiarthroplasty (PDF) (0.16 MB)

• JBJS Article on Total Shoulder Technique (PDF) (1.20 MB)

• JBJS Article on Total Shoulder Result (PDF) (0.14 MB)

Streaming video
Dr. Matsen and Sarah Jackins, physical therapist with the UW Bone and Joint Surgery Center, discuss shoulder surgery with an emphasis on patient involvement in the UWTV video, "Total Shoulder Replacement: Partnership with the Patient".

Surgery for shoulder arthritis at the University of Washington

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